Search

Background: In this study, we describe a participatory design process to develop a technology-based intervention for sun protection for children and their parents. Our methodology embraces and leverages the expert knowledge of the target users, children and their parents, about their sun protection practices to directly influence the design of our mobile just-in-time adaptive intervention (JITAI). The objectives of this paper are to describe our research procedures and summarize primary findings incorporated into developing our JITAI modules. Methods: We conducted 3 rounds of iterative co-design workshops with design expert KidsTeam UW children (N: 11–12) and subject expert children and their parents from local communities in California (N: 22–48). Iteratively, we thematically coded the qualitative data generated by participants in the co-design sessions to directly inform design specifications. Results: Three themes emerged: (1) preference for non-linear educational format with less structure,; (2) situations not conducive for prioritizing sun protection; and (3) challenges, barriers, and ambiguity relating to sun protection to protect oneself and one's family. Based on the design ideas and iterative participant feedback, three categories of modules were developed: personalized and interactive data intake module, narrative-education module with augmented reality experiment, person/real-time tailored JITAI, and assessment modules. Conclusions: This is one of the first projects that maximally engage children and parents as co-designers to build a technology to improve sun protection with iterative and intentional design principles. Our scalable approach to design a mobile JITAI to improve sun protection will lay the foundation for future public health investigators with similar endeavors. [ABSTRACT FROM AUTHOR]

Carpooling has potential as an alternative mode of school transportation along with other viable options, especially at a time when technology continues to increase our reliance upon shared mobility. Unfortunately, our knowledge of carpooling as a school travel mode is very limited. The purpose of this paper is to fill this gap. Using a multinomial logit model, this study presents an analysis of data from the 2012 California Household Travel Survey to assess the effects of various factors, such as trip characteristics, child characteristics, parental or caregiver's characteristics, household characteristics, and spatial variables on choosing carpooling as a school travel mode. The findings of the study indicate that travel distance is one of the major determinants of carpooling, suggesting that children are more likely to carpool to school as travel distance from home to school increases. The analysis shows that a higher income two-parent two-earner family with a 5–15-year-old female schoolchild is more likely to use carpooling for school trips when compared to other modes of transportation. Parental/caregiver characteristics are also found to be important, as children from households with young, female, higher educated heads are more likely to carpool to school. Results of spatial variables suggest that families living in neighborhoods with higher numbers of schoolchildren are also more likely to carpool. The empirical evidence presented in this study provides useful insight to school districts, policymakers, and other transportation related entities in identifying potential target groups to whom this travel mode could be presented. [ABSTRACT FROM AUTHOR]

Recently, the state of California enacted a law requiring radiologists to record the radiation dose that each patient receives for a CT scan. Failure to do so is penalized by law. This law becomes effective in July 2012. By July 2013, every facility that performs CT scans must become accredited by one of three professional groups. This report discusses the role that legislation is playing in the practice of medicine in regard to CT practice. Inherent in this discussion is the assumption that pediatric radiologists know the right dose that a child should receive for a specific clinical indication. But do we really know the answer to this? Compared to the European radiology community, the United States radiology community lags in this regard. This paper defines diagnostic reference levels (DRL) and reviews the history of DRL in the United States compared to that in the European community and the progress by the American College of Radiology's National Radiology Data Registry (NRDR) to establish national registries. The establishment of the first pediatric Quality Improvement Registry in CT Scans in Children (QuIRCC) and its progress to date will be discussed. [ABSTRACT FROM AUTHOR]

In 1994, Stanford University's Exposure Research Group (ERG) conducted its first pilot study to collect micro-level activity time series (MLATS) data for young children. The pilot study involved videotaping four children of farm workers in the Salinas Valley of California and converting their videotaped activities to valuable text files of contact behavior using video-translation techniques. These MLATS are especially useful for describing intermittent dermal (i.e., second-by-second account of surfaces and objects contacted) and non-dietary ingestion (second-by-second account of objects or hands placed in the mouth) contact behavior. Second-by-second records of children contact behavior are amenable to quantitative and statistical analysis and allow for more accurate model estimates of human exposure and dose to environmental contaminants. Activity patterns data for modeling inhalation exposure (i.e., accounts of microenvironments visited) can also be extracted from the MLATS data. Since the pilot study, ERG has collected an immense MLATS data set for 92 children using more developed and refined videotaping and video-translation methodologies. This paper describes all aspects required for the collection of MLATS including: subject recruitment techniques, videotaping and video-translation processes, and potential data analysis. This paper also describes the quality assurance steps employed for these new MLATS projects, including: training, data management, and the application of interobserver and intraobserver agreement during video translation. The discussion of these issues and ERG's experiences in dealing with them can assist other groups in the conduct of research that employs these more quantitative techniques.Journal of Exposure Science and Environmental Epidemiology (2006) 16, 287–298. doi:10.1038/sj.jea.7500459; published online 12 October 2005 [ABSTRACT FROM AUTHOR]

This paper is the third in a series of reports on preliminary empirical findings from replications of an integrated system of care for youth suffering from serious emotional disturbance. The development of the innovative .system of care was pioneered in Ventura County, California, and the replications in three other California counties were legislatively enabled through California legislation (Assembly Bill 377). This report presents results on the expenditure and utilization of foster homes, residential placements made through special education programs, and state hospitals. Evaluation results indicate that foster home and state hospital utilization and expenditures are lower for the counties replicating the innovative system of care than for the state of California as a whole. Expenditures for special education residential placements are either at the state rate or lower in one county. The cumulative evidence supports the conclusion that the replication counties are utilizing restrictive levels of care at lower rates than would be expected given state-wide patterns. The results, in conjunction with prior findings, are discussed in the context of questions about the possible fates of youth who no longer live in publicity funded residential facilities. [ABSTRACT FROM AUTHOR]

Background: Despite being disproportionately impacted by COVID-19 due to a lack of structural support, marginalized communities have been largely ignored in the politically polarized debate over school masking. In response to this, we sought to explore masking attitudes by centering the voices of parents and children at historically marginalized, predominantly Hispanic schools in southern California. Methods: We conducted a mixed-methods study with parents and children attending 26 low-income predominantly Hispanic-serving elementary schools. A random sample of parents was asked to provide a freelist of words they associate with masking. A subset of parents with children aged 4–6 was recruited from these surveys to participate in parent-child interviews (PCI). We calculated Smith's salience index for all unique items, stratifying by language (English/Spanish). Item salience guided PCI thematic analysis for additional context and meaning. Results: 648 participants provided 1118 unique freelist items in English and Spanish. 19 parent-child pairs were interviewed, 11 in Spanish and 8 in English. The most salient words were "safety"(0.37), "protection"(0.12), "prevention"(0.05), "health"(0.04), "good"(0.03), "can't breathe"(0.03), "necessary"(0.02), "care"(0.02), "precaution"(0.02), and "unnecessary"(0.02). Spanish speakers had a more favorable view of masking than English speakers, particularly regarding "protection" (0.20 vs 0.08) and "prevention" (0.10 vs 0.02). Discussion: Masking is an affordable individual-level risk mitigation that protects the communities that have inequitably shouldered the burdens of the COVID-19 pandemic. We recommend that policymakers prioritize the views of those most impacted when deciding on risk mitigation policies like school masking. [ABSTRACT FROM AUTHOR]

The Study to Explore Early Development (SEED) is a multi-site case-control study designed to explore the relationship between autism spectrum disorder (ASD) phenotypes and etiologies. The goals of this paper are to (1) describe the SEED algorithm that uses the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) to classify children with ASD, (2) examine psychometric properties of different ASD classification methods, including the SEED method that incorporates rules for resolving ADI-R and ADOS discordance, and (3) determine whether restricted interests and repetitive behaviors were noted for children who had instrument discordance resolved using ADI-R social and communication scores. Results support the utility of SEED criteria when well-defined groups of children are an important clinical or research outcome. [ABSTRACT FROM AUTHOR]

Background: Angiotensin II type-1 receptor antibody (AT1R-Ab) has been associated with vascular injury and kidney dysfunction in pediatric kidney transplant recipients. The role of AT1R-Ab in the development of chronic kidney disease in pediatric liver and intestinal transplant recipients has not been explored. Methods: Twenty-five pediatric intestinal transplant recipients and 79 pediatric liver transplant recipients had AT1R-Ab levels measured at varying time points in the post-transplant period. Estimated glomerular filtration rate (eGFR) was determined using creatinine based CKiD U25 equation and measured at time of AT1R-Ab measurement, at 1 year post-AT1R-Ab measurement, at 5 years post-AT1R-Ab measurement, and at the most recent routine clinic visit. The prevalence of hypertension and antihypertensive medication use were also evaluated. Results: Younger age at time of AT1R-Ab measurement was associated with AT1R-Ab positivity in liver transplant recipients. There was no association between AT1R-Ab status and change in eGFR, prevalence of hypertension, or use of antihypertensive medications at the described time points. Conclusions: AT1R-Ab positivity was not associated with a decline in eGFR or hypertension in pediatric liver and intestinal transplant recipients. Further studies are needed using other markers of kidney function, such as cystatin C, to validate this finding. [ABSTRACT FROM AUTHOR]

Background: This paper outlines conclusions from a three-day workgroup hosting the eight authors as well as others with expertise in the evaluation and treatment of youth exposed to war and violence. Objective: The purpose of this meeting was to bring multiple perspectives together to identify components that comprise effective psychosocial interventions for child victims of war and community violence across cultures. The meeting also sought to identify gaps in the existing treatment approaches. Method: In the meeting, personal experiences and previous research were discussed to develop a wide-ranging intervention approach, determine a cohesive definition for 'indirect' exposure, and identify successful methods of intervention delivery for youth exposed to acts of war and violence. Results and Conclusions: Key components of intervention for youth exposed to war/violence, important outcome measures, and cultural differences that may influence effective intervention were identified. A clearer definition of 'indirect' exposure was also developed. Finally, a nine-phase model was developed to provide guidelines for establishing partnerships between trauma teams and other organizations or schools to implement and disseminate treatment for this population. [ABSTRACT FROM AUTHOR]

Family, friend and neighbor (FFN) child caregivers represent a significant proportion of caregivers for young children. Yet, these caregivers receive little support for their services. In 2003, the First 5 California Children and Families Commission (First 5 California) began a study to determine the work-related needs of FFN caregivers in California. This paper reports on the results of all study activities, including focus groups and interviews with caregivers and parents. It details the specific needs related to licensing, materials and equipment, education and training, and support systems that were identified by FFN caregivers, parents, and other stakeholders as being important to improve the quality and working conditions of FFN care. It also discusses needs of agencies that provide services to FFN caregivers, including awareness of and knowledge about the population, funding and other resources, and professional development topics. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of current study was to evaluate change in hours of Applied Behavior Analysis (ABA) therapy utilization for autistic children during the year prior to the COVID-19 pandemic, the first three months of the pandemic (crisis phase), and the following 9 months of the pandemic (mitigation phase). Additionally, this study aimed to evaluate if change in therapy utilization differed based on child race, ethnicity, and primary payer of services. Finally, we aimed to identify potential mechanisms of ABA therapy disruption by interpreting findings using an extended version of Donabedian's structure-process-outcome model. Methods: Retrospective clinical data on client demographics and therapy utilization (n = 283) were collected from ABA clinics in California and analyzed with four piecewise growth multi-level models. Results: We found that therapy utilization dropped during the first three months of the pandemic (-10.65 h/month; p <.001) and increased during the following 9 months (2.39 h/month; p <.001). Moderator analyses revelated that Asian, Non-Latinx and school-district funded children had significantly different trajectories of change in therapy utilization compared to white, non-Latinx participants and private insurance funded participants, respectively. Conclusion: Findings suggest that utilization of ABA therapy was disrupted for a full year following the onset of the COVID-19 pandemic and that child race/ethnicity and primary payer influenced the degree to which autistic children were impacted by service disruption. These findings have implications for autistic children who lost therapy access during key developmental periods and for the ABA care delivery system. [ABSTRACT FROM AUTHOR]

Mindfulness-based interventions (MBIs) may offer a means for Latinx families to ameliorate stress, enhance emotion regulation, and foster social support. We assessed pilot data from Latinx parents in Eastside Los Angeles (n = 27) matched with their children aged 10–16 (n = 32) to determine whether participation in a community-derived MBI was associated with greater improvements in dispositional mindfulness, perceived stress, emotion regulation, and family social support compared to a control condition. Compared to the control group, parents in the MBI group showed greater reductions in perceived stress scale (PSS) scores (B = − 2.94, 95% CI [− 5.58, − 0.39], p = 0.029), while their children reported greater increases in perceived social support from family (B = 2.32, 95% CI [0.26, 4.38], p = 0.027). Findings show a community-derived MBI may improve stress in Latinx parents and social support for their children. [ABSTRACT FROM AUTHOR]

Early life exposures have been associated with obesity later in life. We aim to assess the association between early life exposure to food insecurity and change in BMI throughout childhood and adolescents. Food security status and growth variables from 243 Mother–child dyads from the Center for the Health Assessment of Mothers and Children of Salinas study were assessed 7 times over a 12-year period. Generalized log linear models with Poisson distributions and linear regression models were implemented to assess the associations between early life food insecurity and obesity and growth. Early life food insecurity was associated with a 0.43 (0.01, 0.82) kg/m2 decrease in BMI from age 2 to 3.5, and a 0.92 kg/m2 (0.38, 1.46) increase in BMI among boys from ages 3.5 to 5, after adjusting for covariates. Sex and age modify the association between early life exposure to food insecurity and BMI. [ABSTRACT FROM AUTHOR]

Purpose: Residential mobility is considered as a potential source of confounding in studies assessing environmental exposures, including in studies of electromagnetic field (EMF) exposures and childhood leukemia.Methods: We present a hybrid simulation study where we simulate a synthetic dataset based on an existing study and use it to assess the sensitivity of EMF-leukemia associations to different scenarios of uncontrolled confounding by mobility under two major hypotheses of the infectious etiology of childhood leukemia. We then used the findings to conduct sensitivity analysis and empirically offset the potential bias due to unmeasured mobility in the California Power Line Study dataset.Results: As expected, the stronger the assumed relationship between mobility and exposure and outcome, the greater the potential bias. However, no scenario created a bias strong enough to completely explain away previously observed associations.Conclusions: We conclude that uncontrolled confounding by residential mobility had some impact on the estimated effect of EMF exposures on childhood leukemia, but that it was unlikely to be the primary explanation behind previously observed largely consistent, but unexplained associations. [ABSTRACT FROM AUTHOR]

This study explored the adjustment phase of the resiliency model of family adjustment and adaptation, particularly how stress and food insecurity interact with protective mechanisms to influence children's dietary adjustment. With increasing rates of Hispanic childhood obesity and disproportionate health disparities, this is an issue that must be better understood. Altogether, 137 Mexican immigrant mothers from Illinois and California completed questionnaires reporting their stressors, protective mechanisms, and family health behaviors. Multiple regression analyses revealed that higher perceived stress levels for mothers predicted non-nutritive snacking reasons. Furthermore, mother's dietary patterns predicted child's poor dietary quality. Taken together, maternal stressors play a role in family health behaviors, and future studies should consider household food environment factors when trying to understand protective mechanisms for families. [ABSTRACT FROM AUTHOR]

Predictors of the physical and relational aggressive behavior of children in foster care were examined ( N = 160, 50.9% male, M age = 7.57, SD = 2.39). First, predictors representative of children's placement histories were examined in relation to the children's aggression at T1. Next, predictors representing characteristics of the current family environment were examined in relation to the children's aggression at T2 (4 months later). Results revealed that a greater number of prior group home placements and being in a non-kinship home were associated with higher physical aggression at T1. A greater number of prior group home placements, a fewer number of regular home placements, being in a non-kinship home, and prior removal from the home due to neglect were associated with higher relational aggression at T1. The results also revealed that higher foster sibling relational aggression at T1 predicted lower child physical aggression at T2. If foster siblings were biological children of the foster parent, higher levels of a foster sibling's physical aggression at T1 predicted reduced child physical aggression at T2. The opposite pattern was observed if foster siblings were not biological children of the foster parent. Lastly, longer time in the current placement, more children in the home, and the presence of a sibling that was a biological child of the parent predicted higher child relational aggression at T2. These findings provide initial insights into how placement history and current family environment are associated with the physical and relational aggressive behavior of children in foster care. [ABSTRACT FROM AUTHOR]

Perceived loneliness and social competence were assessed for 127 children with ASD without comorbid ID, 4-7 years old, through child self-report. Using an abbreviated version of the Loneliness and Social Dissatisfaction Questionnaire (LSDQ; Cassidy and Asher in Child Dev 63:250-365, ), the majority of children reported friendships, yet a considerable proportion also reported social difficulties. Factor analysis of the abbreviated LSDQ identified three factors, which were significantly associated with parent- and teacher-reported variables. Regression analyses revealed parent-reported social skills deficits and teacher-reported conflict in the student-teacher relationship to be associated with child-reported loneliness. Implications for practice are discussed. [ABSTRACT FROM AUTHOR]

A multiple baseline design across participants was used to examine the effects of a portable video modeling intervention delivered in the natural environment on the verbal compliments and compliment gestures demonstrated by five children with autism. Participants were observed playing kickball with peers and adults. In baseline, participants demonstrated few compliment behaviors. During intervention, an iPad was used to implement the video modeling treatment during the course of the athletic game. Viewing the video rapidly increased the verbal compliments participants gave to peers. Participants also demonstrated more response variation after watching the videos. Some generalization to an untrained activity occurred and compliment gestures also occurred. Results are discussed in terms of contributions to the literature. [ABSTRACT FROM AUTHOR]

Previous research has generally found exclusive breastfeeding to protect against asthma in young children. However, maternal nativity in a Latina population has not been assessed as a potential confounder or effect modifier. Using cross-sectional data restricted to Latina mothers (n = 704) from a birth cohort in Los Angeles interviewed in 2003 and 2006, we estimated risk ratios (RR) for exclusive breastfeeding and asthmatic symptoms in the offspring. 56 children (8 %) had asthmatic symptoms at age 3.5 years. We found a 49 % reduction in risk of asthmatic symptoms with >3 months of exclusive breastfeeding (aRR 0.51, 95 % CI 0.28, 0.90). Foreign-born Latinas were more likely to initiate and continue breastfeeding for at least 3 months compared with US-born Latinas. Three or more months of exclusive breastfeeding reduced the risk of asthmatic symptoms in the offspring of Latinas, and maternal nativity did not confound or modify this association. [ABSTRACT FROM AUTHOR]

Inland southern California is a region of public health concern, especially for children, given the area's perennially poor air quality and increasing sources of local pollution. One elementary school specifically is located only a few hundred yards from the San Bernardino Railyard, one of the busiest goods movement facilities in California, potentially increasing respiratory problems. Through ENRRICH (Environmental Railyard Research Impacting Community Health) Project, we assessed association of proximity to a major freight railyard on adverse respiratory health in schoolchildren. Respiratory screening was provided for children at two elementary schools: one near the railyard and a socio-demographically matched comparison school 7 miles away. Screening included testing for airway inflammation (F e), lung function (peak expiratory flow, PEF) and parent reported respiratory symptoms. Parental questionnaires collected additional information. Log-binomial and linear regression assessed associations. Children attending school near the railyard were more likely to exhibit airway obstruction with higher prevalence of abnormal PEF (<80 %): prevalence ratio (PR) = 1.59 (95 % CI 1.19-2.12). The association with inflammation was less clear. Children at the exposure school, who had lived 6 months or longer at their current address (vs. all children at that school) were more likely to have values suggesting inflammation (F e > 20 ppb) (PR = 1.44, 95 % CI 1.02-2.02) and present with a trend for increased adverse respiratory symptoms. Children attending school near the railyard were significantly more likely to display respiratory health challenges. Ideally these low-income, low resource communities should be supported to implement sustainable intervention strategies to promote an environment where children can live healthier and thrive. [ABSTRACT FROM AUTHOR]

Williams syndrome (WS) and autism spectrum disorder (ASD) are associated with atypical social-emotional functioning. Affective visual stimuli were used to assess autonomic reactivity and emotion identification, and the social responsiveness scale was used to determine the level social functioning in children with WS and ASD contrasted with typical development (TD), to examine syndrome-specific and syndrome-general features. Children with ASD exhibited the highest arousal in response to faces, with a lack of difference in autonomic sensitivity across different emotional expressions, unlike in WS and TD. The WS group demonstrated unique deficits in identifying neutral stimuli. While autonomic responsivity to neutral faces was associated with social functioning in all children, converging profiles characterized children with WS contrasted with TD and ASD. [ABSTRACT FROM AUTHOR]

This is a pilot study of the effectiveness of Project ImPACT, a parent-mediated intervention for ASD delivered in a community program. The primary aim was to compare child and parent outcomes between the intervention group and a community comparison for 30 young children with ASD at baseline and 12 weeks. The secondary aim was to identify parent factors associated with changes in child outcomes. Results indicated significant improvement in child communication skills and a strong trend for parent intervention adherence for the intervention group from baseline to 12 weeks. Higher baseline parenting stress was negatively related to child social gains from baseline to 12 weeks. Findings provide further support for delivering parent-mediated interventions in community settings to children with ASD. [ABSTRACT FROM AUTHOR]

This study examined the extent to which a computer-based social skills intervention called FaceSay™ was associated with improvements in affect recognition, mentalizing, and social skills of school-aged children with Autism Spectrum Disorder (ASD). FaceSay™ offers students simulated practice with eye gaze, joint attention, and facial recognition skills. This randomized control trial included school-aged children meeting educational criteria for autism ( N = 31). Results demonstrated that participants who received the intervention improved their affect recognition and mentalizing skills, as well as their social skills. These findings suggest that, by targeting face-processing skills, computer-based interventions may produce changes in broader cognitive and social-skills domains in a cost- and time-efficient manner. [ABSTRACT FROM AUTHOR]

Impairments in sensorimotor integration are reported in Autism Spectrum Disorder (ASD). Poor control of balance in challenging balance tasks is one suggested manifestation of these impairments, and is potentially related to ASD symptom severity. Reported balance and symptom severity relationships disregard age as a potential covariate, however, despite its involvement in balance development. We tested balance control during increasingly difficult balance conditions in children with ASD and typically developing peers, and investigated relationships between balance control and diagnostic/symptom severity metrics for participants with ASD, including age as a covariate. Balance deficits in ASD were exacerbated by stance alterations, but were not related to symptom severity when age was considered. These findings support impaired balance in ASD, especially in challenging conditions, but question a link between balance and symptom severity. [ABSTRACT FROM AUTHOR]

The present study evaluated the ability of males with fragile X syndrome (FXS), nonsyndromic autism spectrum disorder (ASD), or typical development to learn new words by using as a cue to the intended referent an emotional reaction indicating a successful (excitement) or unsuccessful (disappointment) search for a novel object. Performance for all groups exceeded chance-levels in both search conditions. In the Successful Search condition, participants with nonsyndromic ASD performed similarly to participants with FXS after controlling for severity of ASD. In the Unsuccessful Search condition, participants with FXS performed significantly worse than participants with nonsyndromic ASD, after controlling for severity of ASD. Predictors of performance in both search conditions differed between the three groups. Theoretical and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

The current study examined relationships between children's ethnic produce exposure and healthy dietary practices among Latino, Hmong and non-Hispanic white children. One hundred Latino, 100 Hmong, and 92 non-Hispanic white parents of children ages 5-8 years old in northern California completed a cross-sectional survey. Children's exposure to ethnic produce from Hmong and Latino cultures, overall fruit and vegetable consumption, and fast food and ethnic restaurant use were measured. The Kruskal-Wallis and Mann-Whitney tests were used to compare variables across different ethnic groups. Spearman's correlation was used to assess the relationship between variables. Children's overall ethnic produce exposure, as well as exposure to produce from other cultures, was significantly correlated with overall fruit and vegetable consumption. There was a marginal ( p = 0.053) negative association between ethnic produce exposure and fast food restaurant use among Latino children. These findings suggest that promoting ethnic produce is an effective strategy for enhancing healthy dietary practices among children. [ABSTRACT FROM AUTHOR]

Exposure to US culture is negatively associated with fruits and vegetables (F&V) intake. Our goal was to investigate how parent's nativity and length of stay in the US influences preschoolers' F&V intake. We analyzed survey data from 2,352 children, aged 36-60 months, who participate in the Supplemental Nutrition Program for Women, Infants and Children (WIC) in Los Angeles County. Using multiple linear regression, we examined children's F&V intake by parent's nativity and years in the US, adjusting for possible confounders. Children of foreign born parents who had lived in the US for <10 years consumed fewer servings of vegetables than children of US born parents and of foreign born parents who had lived in the US for ≥10 years. Children of newer immigrant families may be at greater risk for consuming poor-quality diets. Research to identify determinants of poor diet quality among children of immigrant families may increase the effectiveness of WIC in addressing this population's nutritional needs. [ABSTRACT FROM AUTHOR]

Thyroid hormones are critical for normal brain development. This study examined autism spectrum disorders (ASD) and thyroid stimulating hormone (TSH) levels measured in mid-pregnancy maternal serum and infant blood after birth. Three groups of children born in Orange County, CA in 2000-2001were identified: ASD (n = 78), developmental delay (n = 45), and general population controls (GP) (n = 149). Samples were retrieved from prenatal and newborn screening specimen archives. Adjusted logistic regression models showed inverse associations between ASD and log transformed TSH levels in maternal serum samples (ASD vs. GP: OR [95 % CI] 0.33 [0.12-0.91], Early Onset ASD vs. GP: 0.31 [0.10-0.98]). Results for thyroid levels in newborn blood samples were similar though not significant (ASD vs. GP: 0.61 [0.18-2.04]). [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorders (ASD) face pervasive challenges in symbolic and social play development. The Integrated Play Groups (IPG) model provides intensive guidance for children with ASD to participate with typical peers in mutually engaging experiences in natural settings. This study examined the effects of a 12-week IPG intervention on the symbolic and social play of 48 children with ASD using a repeated measures design. The findings revealed significant gains in symbolic and social play that generalized to unsupported play with unfamiliar peers. Consistent with prior studies, the outcomes provide robust and compelling evidence that further validate the efficacy of the IPG model. Theoretical and practical implications for maximizing children's developmental potential and social inclusion in play are discussed. [ABSTRACT FROM AUTHOR]

This field intervention trial evaluated the effect of a 5-week mindfulness-based curriculum on teacher-ratings of student classroom behavior at a Richmond, CA public elementary school, and examined if the addition of more sessions provided added benefit to student outcomes. Seventeen teachers reported on the classroom behaviors of 409 children (83 % enrolled in a California free lunch program and 95.7 % ethnic minority) in kindergarten through sixth grade at pre-intervention, immediate post-intervention, and 7 weeks post-intervention. Results showed that teachers reported improved classroom behavior of their students (i.e., paying attention, self-control, participation in activities, and caring/respect for others) that lasted up to 7 weeks post-intervention. Overall, improvements were not bolstered by the addition of extra sessions, with the exception of paying attention. The implications of this study are limited due to the lack of a mindfulness program-naïve control group, yet findings suggest that mindfulness training might benefit teacher-based perceptions of improved classroom behavior in a public elementary school, which has practice implications for improving the classroom learning environment for lower-income and ethnically-diverse children. [ABSTRACT FROM AUTHOR]

We piloted a suite of approaches aimed to facilitate a successful series of up to four brain and muscle phosphorus-magnetic resonance spectroscopy scans performed in one session in 12 awake, non-sedated subjects (ages 6-18), 6 with autism spectrum disorders (ASD) and 6 controls. We targeted advance preparation, parental input, physical comfort, short scan protocols, allocation of extra time, and subject emotional support. One hundred percent of subjects completed at least one brain scan and one leg muscle scan: 42 of 46 attempted scans were completed (91 %), with failures dominated by exercise muscle scans (completed in 6/6 controls but 3/6 cases). One completed scan lacked usable data unrelated to subject/scan procedure (orthodonture affected a frontal brain scan). As a group, these methods provide a foundation for conduct and enhancement of future MR studies in pediatric subjects with ASD. [ABSTRACT FROM AUTHOR]

The relationship between neighborhood/individual characteristics and pediatric intensive care unit (PICU) outcomes is largely unexplored. We hypothesized that individual-level racial/ethnic minority status and neighborhood-level low socioeconomic status and minority concentration would adversely affect children's severity of illness on admission to the PICU. Retrospective analyses (1/1/2007-5/23/2011) of clinical, geographic, and demographic data were conducted at an academic, tertiary children's hospital PICU. Clinical data included age, diagnosis, insurance, race/ethnicity, Pediatric Index of Mortality 2 score on presentation to the PICU (PIM2), and mortality. Residential addresses were geocoded and linked with 2010 US Census tract data using geographic information systems geocoding techniques. Repeated measures models to predict PIM2 and mortality were constructed using three successive models with theorized covariates including the patient's race/ethnicity, the predominant neighborhood racial/ethnic group, interactions between patient race/ethnicity and neighborhood race/ethnicity, neighborhood socioeconomic status, and insurance type. Of the 5,390 children, 57.8 % were Latino and 70.1 % possessed government insurance. Latino children (β = 0.31; p < 0.01), especially Latino children living in a Latino ethnic enclave (β = 1.13; p < 0.05), had higher PIM2 scores compared with non-Latinos. Children with government insurance (β = 0.29; p < 0.01) had higher PIM2 scores compared to children with other payment types and median neighborhood income was inversely associated with PIM2 scores (β = −0.04 per $10,000/year of income; p < 0.05). Lower median neighborhood income, Latino ethnicity, Latino children living in a predominantly Latino neighborhood, and children possessing government insurance were associated with a higher severity of illness on PICU admission. The reasons why these factors affect critical illness severity require further exploration. [ABSTRACT FROM AUTHOR]

Previous studies of memory in autism spectrum conditions (ASC) have consistently shown that persons with ASC have reduced memories for social information, relative to a spared memory for non-social facts. The current study aims to reproduce these findings, while examining the possible causes leading to this difference. Participants' memory for trait-words was tested after they had viewed the words in three study contexts: visuo-motor, letter-detection, and social judgment. While participants with ASC showed a levels-of-processing effect, such that their memory for words viewed in the social judgment context was greater than their memory for words viewed in the letter-detection context, their memory for socially-processed words was reduced relative to comparison participants. This interaction effect could not be explained by a speed/accuracy trade-off, nor could it be explained solely by differences in encoding. These results suggest that social memory deficits in ASC arise from difficulties both in orienting towards and encoding social content, as well as retaining and retrieving it. Implications for theory and clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Despite higher risk for school failure, few school-based mentoring (SBM) studies have focused on low-income at-risk Latino children. We describe the development and evaluation of the Youth Empowerment Program (YEP), a sustainable, high-quality, SBM program among urban Latino students. Based on evidence from work in other communities, YEP was created as a partnership between the 4th and 5th grades at a Los Angeles Title I elementary school and university undergraduates. We tested the feasibility of applying a previously validated relationship quality assessment tool in this population. Since 2008, 61 mentor and mentee pairs have participated in YEP, with an average relationship length of 1.5 years. Through 2010, over 95 % of pairs had relationships lasting at least 1 year, while 47 % lasted 2 or more years. Seventy-percent of mentees and 85 % of mentors were female, and an increased trend for early relationship termination was observed among male mentees. Through 2011, relationships lasted under 1 year among 29 % of male mentees compared to 7 % of female mentees ( p = 0.15). A previously validated relationship quality assessment tool was easily incorporated into YEP, with relationships exhibiting youth-centeredness, emotional engagement and low dissatisfaction. After 5 years, YEP has become a feasible and sustainable SBM program providing long-term relationships for low-income Latino children. These relationships may improve youth health through fewer risky behaviors and attitude improvements. Future work should focus on supporting male mentors and mentees. [ABSTRACT FROM AUTHOR]

One thousand five hundred parents filling a psychiatric prescription for their 6-18 year old child with a multi-state retail pharmacy chain received a single mailed invitation to complete a detailed online survey. 276 parents responded (18.4 %). 60 % of children on medications had a parent rated CBCL scale score in the clinically significant range at enrollment (T score ≥65), with a similar frequency of clinically significant CBCL scores through 15 months of survey followup. 47 % of medication regimens were noted to be causing persistent side effects. This simple community based data collection method can offer a unique way to investigate naturalistic treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: Normalized protein catabolic rate (nPCR) calculation depends on estimating the urea generation between consecutive hemodialysis (HD) treatments. Two-point nPCR using blood urea nitrogen (BUN) before and after the same HD treatment has not been validated in pediatric patients, who typically receive a more intense HD dose than adults. This study aimed to compare nPCR calculated with a two-point vs. a three-point nPCR model in pediatric HD patients. Methods: Pediatric patients receiving HD at 2 units were enrolled. Three BUN measurements were obtained around a midweek HD treatment: one prior to HD (preBUN1), one 30 s after HD (30sBUN), and one prior to the subsequent HD (preBUN2). The two-point nPCR model was calculated using preBUN1 and 30sBUN and the three-point nPCR model was calculated using preBUN2 and 30sBUN. Results: Seventy-six BUN sets from 35 patients were analyzed. Mean age was 16.4 ± 3.5 years. Mean dry weight was 51.4 ± 17.1 kg. Mean spKt/V was 1.54 ± 0.23. Mean preBUN2 was significantly lower than mean preBUN1 (60.2 ± 18.6 vs. 64.0 ± 18.9 mg/dl, p = 0.0001). nPCR obtained from the three-point model was significantly lower than nPCR obtained from the two-point model (1.07 ± 0.31 vs. 1.17 ± 0.31 g/kg/day, p = 0.00001). Seven of 76 (9.2 %) paired comparisons yielded three-point nPCR <1 vs. two-point nPCR >1. Conclusions: Our data show that in pediatric patients receiving HD, the ((1) two-point and three-point models lead to significantly different nPCRs, and (2) inaccurate protein intake assessment may result from reliance on a two-point model for nPCR estimates. [ABSTRACT FROM AUTHOR]

Research suggests that improvements to community mental health (CMH) care for children with autism spectrum disorders (ASD) are needed. Recent research examining the feasibility of training CMH therapists to deliver a package of evidence-based practice intervention strategies (EBPs) targeting challenging behaviors for school-age children with ASD offers initial support for such efforts to improve care. Specifically, quantitative data from a recent pilot study indicate that CMH therapists with limited ASD experience can deliver an EBP intervention with fidelity and perceive it as useful to their practice. Further, client attendance is high and children demonstrate improvement on standardized measures. To further understand the feasibility and impact of training CMH therapists to deliver EBPs, this mixed-methods study examined parent perspectives of the process and impact of outpatient psychotherapy for 13 parents of children ages 5-13 with ASD whose therapists were trained to deliver the EBP intervention. Results complement and expand previously reported quantitative data on psychotherapy process indicating that parents are highly involved in treatment for their children, perceive a strong therapeutic alliance with their children's therapist, and highlight that treatment was different once therapists began delivering the intervention. Results also indicate themes related to parents' perceptions of positive child and parent outcomes that provide important details on the specific gains that were observed during treatment. Study findings underscore the importance of parent perspectives in understanding the process and impact of implementing EBPs in CMH settings for families of children with ASD. [ABSTRACT FROM AUTHOR]

The present study was part of a larger randomized controlled childhood obesity prevention trial based in 11 public recreation centers. The primary aim was to evaluate the effectiveness of a multi-level intervention to prevent the onset of overweight and obesity among children (5-8 years of age). However, the purpose of the current study was to identify sociodemographic variables, such as acculturation, that were associated with receipt of physician advice among Latino primary caregivers. Participants included 221 Latino primary caregivers and their children from San Diego, CA. Cross-sectional baseline data suggested that Latino children with private insurance were more likely to receive physician advice regarding their eating habits. Conversely, primary caregivers between the ages of 30-39 were less likely to receive physician advice regarding their child's eating habits. Current findings highlight the continued need to improve preventive efforts and reduce health disparities among a vulnerable population, such as Latinos. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the association of parent acculturation with child fruit and vegetable consumption and obesity, as measured by body mass index (BMI). Participants included 250 Mexican-American and other Hispanic families living within San Diego County. Height and weight measurements were collected to calculate the age- and sex-specific BMI for each child and parent, and parents completed self-administered surveys. Child BMI z-score was significantly related to parent BMI after controlling for parent acculturation and parent birth place (β = 0.05, p < 0.01). Child fruit consumption was significantly associated with parent acculturation (β = −0.02, p = 0.01) and parent BMI (β = 0.02, p = 0.04) after adjusting for the other variables in the model. Child vegetable consumption was not significantly related to parent acculturation. Findings suggest that parental weight status may be more predictive of child obesity than acculturation, and highlight the need to examine culturally relevant behavioral and psychosocial factors related to childhood obesity and dietary behaviors. [ABSTRACT FROM AUTHOR]

The psychometric properties of the Pediatric Anxiety Rating Scale (PARS), a clinician-administered measure for assessing severity of anxiety symptoms, were examined in 72 children and adolescents diagnosed with an autism spectrum disorder (ASD). The internal consistency of the PARS was 0.59, suggesting that the items were related but not repetitive. The PARS showed high 26-day test-retest (ICC = 0.83) and inter-rater reliability (ICC = 0.86). The PARS was strongly correlated with clinician-ratings of overall anxiety severity and parent-report anxiety measures, supporting convergent validity. Results for divergent validity were mixed. Although the PARS was not associated with the sum of the Social and Communication items on the Autism Diagnostic Observation System, it was moderately correlated with parent-reported inattention, aggression and externalizing behavior. Overall, these results suggest that the psychometric properties of the PARS are adequate for assessing anxiety symptoms in youth with ASD, although additional clarification of divergent validity is needed. [ABSTRACT FROM AUTHOR]

Individuals with autism spectrum disorder (ASD) have distinctive needs with respect to sexual development and education. This pilot study evaluates the effectiveness of a parent-implemented Social Story intervention with an embedded visual task analysis to teach menstrual care skills to three young girls with ASD. Skill generalization was evaluated using two different types of pads and a simulated condition (i.e., a pad with red syrup). Social validity of target behaviors, intervention procedures and intervention effects were evaluated. Additionally, qualitative changes in participant behaviors were measured via phone interviews with the participants' mothers (Bruess and Greenberg ) 1 year later. Results indicate that participants were more knowledgeable about reproductive development and were able to independently care for their menses regardless of pad type (wings vs. no-wings) and condition (clean vs. dirty). Parents reported high satisfaction with the intervention procedures and outcomes. Implications of the study and future research are discussed. [ABSTRACT FROM AUTHOR]

Parent involvement in the treatment of childhood disruptive behavior problems is a critical component of effective care. Yet little is known about the amount of time therapists are involving parents in treatment and factors that predict therapists' efforts to involve parents in routine care. The purpose of this study is to examine therapists' within-session involvement of parents in community-based outpatient mental health treatment. The data are from a larger longitudinal observational study of psychotherapy for children ages 4-13 with disruptive behavior problems and include videotaped psychotherapy sessions coded for the therapeutic strategies delivered as well as measures of child, parent/family, and therapist characteristics at baseline. Parent involvement is defined as the proportion of time in the session that therapists direct treatment strategies towards parents. Results indicated that therapists directed treatment strategies towards parents an average of 44% of the time within a session. Multilevel modeling was used to examine client-level (child, parent, and family functioning) and provider-level (therapist experience and background) predictors of parent involvement. Therapists involved parents more when the child had higher levels of behavior problems, when the parent reported higher levels of internalized caregiver strain, and when the therapist was more experienced. The results highlight potential areas to target in efforts to increase parent involvement, including training less experienced therapists to increase their focus on directing strategies towards parents. [ABSTRACT FROM AUTHOR]

Previous studies have found increased acculturation to the US lifestyle increases risk for obesity in Latinos. However, methodologies differ, and results in children are inconsistent. Moreover, previous studies have not evaluated risk factors within the heterogeneous US population. We recruited 144 self-identified Latino school children and their mother or father in grades 4-6 in San Francisco parochial schools and South San Francisco public schools using an information letter distributed to all students. Children and parents had weights, heights, demographic information, dietary patterns and lifestyle variables collected in English or Spanish through an interview format. A high percentage of our children were overweight [≥85th percentile body mass index (BMI)] (62.5%) and obese (≥95th percentile BMI) (45.2%). Correspondingly parents also had a high percentage of overweight (BMI ≥ 25 & <30) (40.8%) and obesity (BMI ≥ 30) (45.3%). Mexico was the country of origin for 62.2% of parents, and 26.6% were from Central or South America. In multivariate logistic analysis, speaking Spanish at home was an independent risk factor for obesity [odds ratio (OR) 2.97, 95% confidence interval (CI) 1.28-6.86]. Eating breakfast daily (OR 0.34, 95% CI 0.15-0.78) and consumption of tortas (a Mexican fast food sandwich) (OR 0.45, 95% CI 0.21-1.00) were associated with decreased risk. In stratified analysis, significant differences in risk factors existed between Mexican origin versus Central/South American Latino children. The processes of acculturation likely impact eating and lifestyle practices differentially among Latino groups. Interventions should focus on ensuring that all children eat a nutritious breakfast and take into consideration ethnicity when working with Latino populations. [ABSTRACT FROM AUTHOR]

Maladaptive social functioning is a core deficit in children with autism spectrum disorders (ASD). However, few studies have explicitly examined the linkage between anxiety and the degree of social functioning impairment in children with ASD. This study examines several types of anxiety and their covariation with social functioning deficits in children with ASD. Participants were 53 children with ASD who met criteria for at least one anxiety disorder. Within this sample of children, social anxiety disorder was the most common anxiety disorder. Results indicated that a greater severity of social anxiety disorder was associated with a higher level of social functioning deficits for elementary school aged children with ASD. Specifically, exploratory analyses revealed that higher levels of social anxiety disorder predicted lower assertive and responsible social skills. Social anxiety may increase the barriers to social engagement and thus serve as a risk factor for increased social deficits in youth with ASD. [ABSTRACT FROM AUTHOR]

We examined social attention and attention shifting during (a) a play interaction between 12-month olds and an examiner and (b) after the examiner pretended to hurt herself. We coded the target and duration of infants' visual fixations and frequency of attention shifts. Siblings of children with autism and controls with no family history of autism were tested at 12 months and screened for ASD at 36 months. Groups did not differ on proportion of attention to social stimuli or attention shifting during the play condition. All groups demonstrated more social attention and attention shifting during the distress condition. Infants later diagnosed with ASD tended to continue looking at a toy during the distress condition despite the salience of social information. [ABSTRACT FROM AUTHOR]

Using data covering every child born in California from 1961 to 2000, Fryer and Levitt () find that in the 1960s, the differences in name choices by blacks and whites were relatively small, but that a profound shift began among blacks in the mid-1970s toward more distinctively black names, especially among blacks in racially isolated neighborhoods. As an extension of Fryer and Levitt (), this study uses data on the names of about 1,300 white children born over the four-year period from 1997 to 2000 and living in a segment of a Metropolitan Statistical Area in the Deep South, and finds that use of combination first names-largely based on combinations of single names included among the names of high-end white children from Fryer and Levitt () and Levitt and Dubner ()-is significantly more prevalent among high-end white children than it is among low-end white children. Unlike the data described in Fryer and Levitt (), which support an Identity Model wherein distinctively black names result from the Black Power movement that encouraged blacks to 'accentuate and affirm black culture and fight the claims of black inferiority,' the present study suggests that high-end parents may use the combination first name convention to increase the likelihood of the child's future success in various partnership markets, such as dating, marriage and business-partnership markets. [ABSTRACT FROM AUTHOR]

The occurrence of obsessive-compulsive disorder (OCD) in youth with autism spectrum disorders (ASD) is common (37% prevalence or higher) and results in additional distress and impairment. The phenomenology of OCD in youth with ASD is under-researched to date. This study compared the clinical characteristics of youth with comorbid ASD and OCD (ASD + OCD) with age and gender matched controls with OCD in 70 youth (7-13 years old). Youth with both syndromes did not present with more severe OCD symptoms. Obsessive-compulsive symptom severity and total number of obsessions and compulsions between the ASD + OCD group and the OCD group did not differ statistically. However, group differences in reports of specific OCD symptoms as well as patterns of comorbidity were identified. Attention deficit/hyperactivity symptoms, social phobia, and separation anxiety disorder were more common among youth with ASD + OCD. Better understanding of OCD/ASD co-morbidity may facilitate treatment development. [ABSTRACT FROM AUTHOR]

The need to move mental health systems toward more recovery-oriented treatment modes is well established. Progress has been made to define needed changes but evidence is lacking about the resources required to implement them. The Mental Health Services Act (MHSA) in California was designed to implement more recovery-oriented treatment modes. We use data from county funding requests and annual updates to examine how counties budgeted for recovery-oriented programs targeted to different age groups under MHSA. Findings indicate that initial per-client budgeting for Full Services Partnerships under MHSA was maintained in future cycles and counties budgeted less per client for children. With this analysis, we begin to benchmark resource allocation for programs that are intended to be recovery-oriented, which should be evaluated against appropriate outcome measures in the future to determine the degree of recovery-orientation. [ABSTRACT FROM AUTHOR]

Focusing on one family from a study of dual-earner middle-class families carried out in Los Angeles, California, this article draws on interview and video-recorded data of everyday interactions to explore illness and healing as embedded in the microcultural context of the Morris family. For this family, an important aspect of what is at stake for them in their daily lives is best understood by focusing on 9-year-old Mark, who has been diagnosed with attention-deficit/hyperactivity disorder (ADHD). In this article, we grapple with the complexity of conveying some sense of how Mark’s condition is experienced and relationally enacted in everyday contexts. Through illuminating connections between lives as lived and lives as told, we explore the narrative structuring of healing in relation to Mark’s local moral world with the family at its center. We examine how his parents understand the moral consequences of the child’s past for his present and future, and work to encourage others to give due weight to his troubled beginnings before this child joined the Morris family. At the same time, we see how the Morris parents act to structure Mark’s moral experience and orient to a desired future in which Mark’s “success” includes an appreciation of how he is accountable to others for his actions. Through our analyses, we also seek to contribute to discussions on what is at stake in everyday life contexts for children with ADHD and their families, through illuminating aspects of the cultural, moral and relational terrain that U.S. families navigate in contending with a child’s diagnosis of ADHD. Further, given that ADHD is often construed as a “disorder of volition,” we seek to advance anthropological theorizing about the will in situations where volitional control over behavior is seen to be disordered. [ABSTRACT FROM AUTHOR]

To develop a statewide strategic plan for California’s State Early Childhood Comprehensive Systems (SECCS) project using a multi-method qualitative study design. A qualitative study was conducted over 14 months with participants throughout California, including administrators, policy makers, service providers, parents, and statewide administrators. Data collection procedures included interviews, focus groups, a computer-based Delphi study, and meetings of a steering committee. Results were compiled using a triangulation method to identify common themes across the 122 interviews, 24 focus groups with 910 participants, a Delphi study with 14 participants, and discussion with a 20-member interdisciplinary steering committee. The steering committee, comprised of experts in the fields of early education, health, mental health, parent education and family support, participated in the Delphi study. The common themes which led to the formulation of California’s SECCS strategic plan were providing a single point of entry into the system, providing a statewide referral network, integrating funding sources to remove silos of funding, and locating comprehensive services with multidisciplinary teams together. California’s SECCS strategic plan addressed the needs of children from birth through 5 years of age in California and provided goals for how statewide systems can improve access to and quality of services for these children. [ABSTRACT FROM AUTHOR]