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An established body of literature indicates that children with autism spectrum disorder (ASD) have difficulty understanding figurative language due to a deficit in theory of mind, or the ability to consider the beliefs of other people. Children with ASD tend to similarly fail traditional theory of mind tasks, which assess their ability to represent false beliefs. Our claim is, however, that these tasks involve cognitive processing demands that might mask false belief understanding because they require elicited responses. We examined whether children with ASD demonstrate false-belief understanding when tested with a spontaneous-response false belief task that measures children’s eye gaze durations. The two child participant groups were composed of 20 males with ASD (aged 3–9 years) and 20 typically developing males (aged 2–5 years) who were individually matched according to verbal mental age. Children with ASD and typically developing children listened to a change-of-location story accompanied by a book with matching and non-matching pictures. The final page showed the character searching for her object in a location that was either consistent or inconsistent with her belief. Both groups of children looked reliably longer at the belief-consistent picture, regardless of whether the character’s belief was true or false, though children with ASD were slower to do so. We suggest that a spontaneous-response assessment technique can potentially reveal figurative language comprehension in children with ASD in future research.

Fetal alcohol spectrum disorder (FASD) is a prevalent neurodevelopmental disability with significant implications for learning and behaviour. International research suggests that the prevalence of FASD in school-aged children is 2.3-6.3%. In this paper, we address the questions: (1) what is FASD; (2) what is the prevalence of FASD in schools; (3) what is the impact of FASD; and (4) why develop special FASD education strategies and programmes? We summarise the 18-year history of Winnipeg School Division's development of its FASD Programme of services, describe the specialised FASD classrooms and then present the results from a consensus-generating workshop comprised of 36 FASD education professionals, with over 209 years of collective FASD education programme experience, who were asked to identify and reach consensus on best strategies and lessons learned in FASD education programmes. We then suggest that effectively educating children with FASD is critical to get right if positive educational outcomes are to be realised.

Translating to the Community (T2C) is a social biorepository designed to advance new diagnostic tools and realign community--clinical processes, with the aim to mitigate the short- and long-term impacts of fetal alcohol spectrum disorder (FASD) as well as prenatal alcohol exposure and its co-morbidities and behaviors. In this paper, we describe the evolution of this repository as a new translational partnership to advance a precision-medicine approach to FASD. Key to its evolution was a partnership between academic researchers, Indigenous communities, families, and a regional diagnostic clinic. We further describe the rationale for social biobanking, the type of banking, ethical engagement of families, communities, and clinics, their roles in repository design, governance, translation, and research activities, types of data collected from families, and how the study data are managed, reported, and accessed. The repository design includes biological samples, social-contextual healthsurvey data, and clinical data (which are linkable to administrative data) from community and clinical cohorts of diagnosed children, children prenatally exposed but not diagnosed, children suspected to have had a prenatal exposure, and related siblings, biological parents, and unrelated children and their parents. From these cohorts and families, potential studies drawing on this data will shed light on various risk factors, social and biological pathways, and service utilization issues, with the aim to implement primary and secondary prevention and intervention strategies. Key words: fetal alcohol spectrum disorder, social genomic biorepository, translational studies, community and family participation, Indigenous, ethics and governance. << Translating to the Community (T2C) >> (Transfert a la communaute) est un bio-referentiel social concu pour faire progresser le developpement de nouveaux outils diagnostiques et realigner la communaute et les processus cliniques, dans le but d'attenuer les impacts a court et long termes des troubles du spectre de l'alcoolisation foetale (TSAF), de l'exposition prenatale a l'alcool, de leurs comorbidites et des comportements qui leur sont associes. Dans cet article, les auteurs decrivent l'evolution de cereferentiel comme nouvel outil departenariat translationnel afin de promouvoir une approche de medecine de precision dans les TSAF. L'element cle de cette evolution a ete un partenariat entre les chercheurs universitaires, les communautes autochtones, les familles et une clinique regionale de diagnostic. Ils decrivent plus en detail les raisons d'etablir une bio-banque sociale, le type de stockage, l'engagement ethique des familles, des communautes et des cliniques, leur role dans la conception et la gouvernance du referentiel, ainsi que dans les activites de recherche et de transfert realisees, les types de donnees recueillies des familles et comment ces donnees d'etudes sont gerees, rapportees et rendues accessibles. Comme il a ete concu, le referentiel comprend des echantillons biologiques, des donnees d'enquetes sociales, contextuelles et de sante, ainsi que des donnees cliniques (qui peuvent etre correlees aux donnees administratives) a partir des cohortes des communautes et cliniques d'enfants diagnostiques, d'enfants exposes a l'alcool durant la periode prenatale mais non diagnostiques, d'enfants que l'on croit avoir ete exposes a l'alcool durant la periode prenatale et leurs freres et soeurs, leurs parents biologiques, des enfants non apparentes et leurs parents. A partir de ces cohortes et des familles, les etudes potentielles s'appuyant sur ces donnees feront la lumiere sur differents facteurs de risque, les parcours sociaux et biologiques, et les problematiques d'utilisation des services, dans le but de mettre en oeuvre des strategies de prevention et d'intervention primaires et secondaires. [Traduit par la Redaction] Mots-cles : troubles du spectre de l'alcoolisation foetale, bio-referentiel social, etudes translationnelles, participation des communautes et des familles, Autochtone, ethique et gouvernance., Introduction Globally, fetal alcohol spectrum disorder (FASD), a result of a prenatal exposure to alcohol (prenatal alcohol exposure; PAE), is the most common neurodevelopmental condition, exceeding 1% worldwide with an [...]

Accumulating evidence has revealed high rates of sleep disruption among children with fetal alcohol spectrum disorder (FASD). Multiple animal and clinical studies have found a clear association between sleep problems and prenatal alcohol exposure, and recent research is beginning to characterize the types and extent of sleep disruption in FASD. Nevertheless, sleep disruption in children with FASD often goes unrecognized or is treated without referring to an evidence base. Children's disrupted sleep interferes with parental sleep and increases caregiver burden, which is of particular importance for families raising children with FASD, a group with very high levels of caregiving stress. The literature supporting an association between sleep problems and deficits in emotional, behavioral, and cognitive function in children is compelling, but needs further investigation in children with FASD. This paper will review the current state of knowledge on sleep in FASD and recommend a rational approach to sleep interventions for affected children and their families. Key words: FASD, sleep, pediatrics, prenatal alcohol exposure, maternal alcohol use. De plusenplus dedonnees revelent une haute incidence de troublesdu sommeil chez les enfants atteints d'un trouble du spectre de l'alcoolisation foetale (TSAF). Plusieurs etudes cliniques et chez l'animal ont trouve une claire association entre les troubles du sommeil et l'exposition prenatale a l'alcool, et les recherches recentes commencent a caracteriser les types et l'ampleur des perturbations du sommeil dans les TSAF. Neanmoins, les troubles du sommeil chez les enfants atteints de TSAF sont souvent mal ou peu reconnus et sont traites sans references aux donnees probantes. Le sommeil perturbe des enfants interfere avec le sommeil des parents et accroit le fardeau des aidants naturels, ce qui est d'une importance particuliere pour les familles qui elevent les enfants atteints de TSAF, un groupe a hauts niveaux de stress lies aux soins. La litterature qui appuie une association entre les problemes de sommeil et les deficits des fonctions emotionnelles, comportementales et cognitives chez les enfants est irrefutable, mais elle necessite une recherche plus approfondie chez les enfants atteints de TSAF. Cette synthese passera en revue l'etat des connaissances actuelles sur le sommeil dans les TSAF et recommandera une approche rationnelle d'interventions sur le sommeil pour les enfants affectes et leurs familles. [Traduit par la Redaction] Mots-cles : TSAF, sommeil, pediatrie, exposition prenatale a l'alcool, consommation maternelle d'alcool., Introduction Fetal alcohol spectrum disorder (FASD) is characterized by lifelong neurodevelopmental disabilities arising from prenatal exposure to alcohol (PAE) (Stratton et al. 1996; Bertrand et al. 2004; Chudley et al. [...]

Aim: To evaluate patient engagement processes in the development of a new health coaching intervention for parents of children with suspected developmental delays. Method: A cross‐sectional mixed‐method study design was used. Researchers (n=18) and patient‐partners (n=9) were surveyed using the Public and Patient Engagement Evaluation Tool (PPEET) in areas of: (1) communication/supports for participation; (2) sharing views/perspectives; (3) impacts/influence of engagement initiative; and (4) final thoughts/satisfaction. Descriptive statistics and an inductive thematic‐based approach were used to analyse the data. Results: For both study groups, high agreement, with responses largely ranging between 'agree' to 'strongly agree', was noted on all four sections of the PPEET. Qualitative reports reflected that patient engagement was important, meaningful, and had a significant impact on the quality of the project and on the professional development of researchers in their understanding and use of patient‐oriented methodology. Patient‐partners noted challenges related to having realistic deadlines in providing feedback and a lack of a broader range of representation among members. Interpretation: The benefits and challenges of applying patient‐oriented strategies to a multicentre trial were highlighted. These will be used to enhance our engagement processes. This article is commented on by Rethorn on page 631 of this issue. Editor's Choice The current COVID‐19 pandemic has placed a disproportionate additional burden on children with disabilities and their family.1 This experience has also highlighted the crucial role of parents in delivering intervention,2 the value of coaching,3 as well as the importance of quality online resources to that effect.4 My Editor's Choice for the June issue focuses on engagement of expert partners with lived experience in developing an online coaching intervention for caregivers children with a suspected developmental problem. [ABSTRACT FROM AUTHOR]

Objective: To examine health services, social services, education, and justice system outcomes among First Nations children and youth with fetal alcohol spectrum disorder (FASD).Methods: In this retrospective cohort study, health and social services, education, and justice data were linked with clinical records on First Nations (FN) individuals aged 1 to 25 and diagnosed with FASD between 1999 and 2010 (n = 743). We compared the FN FASD group to non-FN individuals with FASD (non-FN FASD; n = 315) and to First Nations individuals (matched on age, sex, and income) not diagnosed with FASD (FN non-FASD; n = 2229). Rates and relative risks (RRs) were calculated using generalized linear models.Results: FN FASD individuals had similar health services use to non-FN FASD individuals but had greater involvement with child welfare (RR, 1.20; 95% confidence interval [CI], 1.02 to 1.41) and the justice system (RR, 1.37; 95% CI, 1.07 to 1.74) and were more likely to be charged with a crime (RR, 1.40; 95% CI, 1.05 to 1.86). There were no suicides/suicide attempts among the non-FN FASD individuals during the study, but the crude rate/100 person-years of suicides among FN FASD individuals (0.22 for females; 1.06 for males) was substantially higher than for FN non-FASD individuals (0.08 for females; 0.32 for males). There were no significant differences between groups in the education outcomes we measured.Conclusions: Young people with FASD are at risk for poor health, education, and social outcomes, but First Nations young people with FASD face comparably higher risks, particularly with child welfare and justice system involvement. The study emphasizes a critical need for appropriate resources for First Nations children with FASD. [ABSTRACT FROM AUTHOR]