The Surplus Effect in Adaptive Behaviour in Down Syndrome: What Can Promote It?

Background: In Down syndrome (DS), adaptive behaviour often shows a “surplus effect” (i.e., higher adaptive abilities than expected from cognitive skills). As inclusive schooling has become mandatory in Italy, we studied the impact of school inclusion on the surplus effect of adaptive behaviour in adult DS, considering potential confounding factors such as parental education. Methods: All consecutive DS individuals from three different sites were queried prospectively regarding type of schooling (inclusive and non-inclusive). Demographic data were documented; cognitive abilities and adaptive behaviour were assessed (Coloured Progressive Matrices and Vineland Adaptive Behaviour Scales). The aim was to establish the presence of a surplus effect in adaptive behaviour, primarily in the overall level and secondarily in the main domains and subdomains. A multivariable-adjusted logistic regression model was used for the association of schooling, and parental education. Results: The majority (65%) showed a surplus effect in adaptive behaviour and had attended inclusive schools (85%). Higher adaptive skills as well as early and longer functional treatment programmes were more readily available for younger individuals. In the group of inclusive schooling, the surplus effect on overall adaptive behaviour was present in 70% as opposed to 38% in the group without inclusive schooling, significant when adjusted for gender and maternal education. This was also observed in socialisation, written, and community, and after adjustment in playing and leisure time. Conclusions: Adaptive behaviour showed a surplus effect in the majority of DS adults, even more so after inclusive schooling. Younger adults showed higher adaptive skills. Moreover, female gender and higher maternal educational level significantly enhanced this surplus effect.

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Parental Education and Offspring Outcomes: Evidence from the Swedish Compulsory School Reform

American Economic Journal Applied Economics ◽

10.1257/app.6.1.253 ◽

2014 ◽

Vol 6 (1) ◽

pp. 253-278 ◽

Cited By ~ 32

Author(s):

Petter Lundborg ◽

Anton Nilsson ◽

Dan-Olof Rooth

Keyword(s):

Health Status ◽

School Reform ◽

Cognitive Skills ◽

Parental Education ◽

Maternal Education ◽

Causal Effect ◽

Noncognitive Skills ◽

Market Returns ◽

Compulsory School ◽

Positive Effects

We use the Swedish compulsory school reform to estimate the causal effect of parental education on sons’ outcomes. To this end, we use data from the Swedish military enlistment register on the entire population of males and consider outcomes, such as cognitive skills, noncognitive skills, and various dimensions of health at the age of 18. We find positive effects of maternal education on sons’ skills and health status but no effects of paternal education. One reason behind this result may be that the fathers affected by the reform did not face any labor market returns to their increased schooling. (JEL I21, J12, J24)

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Sibling Similarity in Education Across and Within Societies

Demography ◽

10.1215/00703370-9164021 ◽

2021 ◽

Author(s):

Michael Grätz ◽

Kieron J. Barclay ◽

Øyvind N. Wiborg ◽

Torkild H. Lyngstad ◽

Aleksi Karhula ◽

...

Keyword(s):

United States ◽

Educational Attainment ◽

Cognitive Skills ◽

Parental Education ◽

Family Background ◽

The United States ◽

School Grades ◽

Sibling Correlations ◽

Sibling Similarity ◽

The Impact

Abstract The extent to which siblings resemble each other measures the omnibus impact of family background on life chances. We study sibling similarity in cognitive skills, school grades, and educational attainment in Finland, Germany, Norway, Sweden, the United Kingdom, and the United States. We also compare sibling similarity by parental education and occupation within these societies. The comparison of sibling correlations across and within societies allows us to characterize the omnibus impact of family background on education across social landscapes. Across countries, we find larger population-level differences in sibling similarity in educational attainment than in cognitive skills and school grades. In general, sibling similarity in education varies less across countries than sibling similarity in earnings. Compared with Scandinavian countries, the United States shows more sibling similarity in cognitive skills and educational attainment but less sibling similarity in school grades. We find that socioeconomic differences in sibling similarity vary across parental resources, countries, and measures of educational success. Sweden and the United States show greater sibling similarity in educational attainment in families with a highly educated father, and Finland and Norway show greater sibling similarity in educational attainment in families with a low-educated father. We discuss the implications of our results for theories about the impact of institutions and income inequality on educational inequality and the mechanisms that underlie such inequality.

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Correlates of adaptive skills in children with autism spectrum disorder

Autism ◽

10.1177/1362361321997287 ◽

2021 ◽

pp. 136236132199728

Author(s):

Ramkumar Aishworiya ◽

Tze Jui Goh ◽

Min Sung ◽

Stacey Kiat Hong Tay

Keyword(s):

Autism Spectrum Disorder ◽

Early Intervention ◽

Waiting Time ◽

Economic Status ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Adaptive Skills ◽

Adaptive Behaviour ◽

Vineland Adaptive Behaviour Scales

This study aimed to identify potential modifiable factors prior to early intervention that are associated with better adaptive skills in children with autism spectrum disorder. This cross-sectional study recruited patients with autism spectrum disorder, aged 5–12 years from two tertiary developmental programmes in Singapore. Demographics, family socio-economic status and early intervention details were collected. The primary outcome was the Vineland Adaptive Behaviour Scales Adaptive Behaviour Composite score. Multivariate linear regression analysis was done. The sample ( N = 193) comprised 84% males with a mean age of 6 years and 7 months. Mean age at diagnosis was 35.5 months and mean Vineland Adaptive Behaviour Scales Adaptive Behaviour Composite standard score was 76.5. Mean waiting time for early intervention was 6.2 months with a mean intensity of 8.0 h/week. Waiting time for early intervention was a negative correlate of the Vineland Adaptive Behaviour Scales Adaptive Behaviour Composite score after controlling for other variables ( β = −0.74, p = 0.04). Significant correlates also included paternal education ( β = 5.44, p = 0.03) and the presence of financial difficulties in the family ( β = −5.98, p = 0.04). Waiting time for early intervention is a modifiable risk factor that may be addressed during service planning to potentially improve adaptive skills in autism spectrum disorder. Children from low socio-economic status families may be at risk for poor functional skills and will benefit from targeted intervention plans. Lay abstract Despite improving services and care for individuals with autism spectrum disorder, functional outcomes such as daily living skills tend to be suboptimal for many. This study wanted to identify modifiable early intervention factors that are associated with better outcomes and possible high-risk groups of children who are at risk of poorer outcomes. Participants included 193 children aged between 5 and 12 years of age whose parents provided information on their family background and early intervention characteristics. These children also had their adaptive behaviour skills examined by formal testing. Results indicated that shorter wait time for early intervention was associated with better adaptive behaviour scores. Children from families with financial difficulties and lower paternal education were also at risk of poorer adaptive skills. Designing services for children with autism such that wait times to enter early intervention services are minimised following initial diagnosis can improve their eventual functional outcomes. Changes in healthcare policy to allow expedited entry or targeted intervention to children from low socio-economic status families can also enhance their eventual adaptive skill gains.

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Sociodemographic Differences in Prenatal Diagnosis of Chromosomal Anomalies: A Population-Based Study

Frontiers in Pediatrics ◽

10.3389/fped.2021.630363 ◽

2021 ◽

Vol 9 ◽

Author(s):

Michele Santoro ◽

Lorena Mezzasalma ◽

Alessio Coi ◽

Silvia Baldacci ◽

Lucia Pasquini ◽

...

Keyword(s):

Down Syndrome ◽

Prenatal Diagnosis ◽

Maternal Education ◽

Geographic Origin ◽

Population Based ◽

Termination Of Pregnancy ◽

Chromosomal Anomalies ◽

Essential Information ◽

Maternal Characteristics ◽

The Impact

Background: In Europe, about 76% of cases of chromosomal anomalies are prenatally diagnosed. Prenatal diagnosis allows more efficient planning of postnatal treatment and helps parents for an informed decision about the continuation of pregnancy. The main aim of this study was to evaluate whether the sociodemographic maternal characteristics affect the probability of prenatal diagnosis of chromosomal anomalies.Methods: Cases of chromosomal anomalies in the period 2005–2017 came from the population-based registry of congenital anomalies of Tuscany (Italy). Differences in the proportion of cases prenatally diagnosed were investigated through the following maternal characteristics: education, geographic origin and occupation. The association between cases of termination of pregnancy after prenatal diagnosis and maternal characteristics was also analysed. Odds Ratios (OR) adjusted by maternal age were calculated using logistic regression models. Results were provided for all cases of chromosomal anomalies and for Down syndrome cases.Results: A total of 1,419 cases were included in the study. Cases prenatally diagnosed were 1,186 (83.6%). We observed a higher proportion of cases not prenatally diagnosed among cases with low maternal education compared to those with high maternal education (OR = 2.16, p < 0.001) and in women from high migratory outflow countries, compared to the Italian ones (OR = 2.85, p < 0.001). For prenatally diagnosed Down syndrome cases, we observed a higher proportion of termination of pregnancy for women with low education level (OR = 4.36, p = 0.023).Conclusions: In our study evidence of differences in the probability of prenatal diagnosis of chromosomal anomalies associated with maternal education and geographic origin was found. Population-based studies investigating sociodemographic disparities can provide essential information for targeted public health programs. Further studies are recommended to monitor the impact of the increasing availability of non-invasive screening tests.

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Behavioural Concerns of Children on the Autism Spectrum and the Impact on Parental Quality of Life

10.21203/rs.3.rs-330735/v1 ◽

2021 ◽

Author(s):

Raisa Islam ◽

Syeda Ishra Azim ◽

Anne Masi ◽

Louis Klein ◽

Valsamma Eapen

Keyword(s):

Quality Of Life ◽

Autism Spectrum ◽

Adaptive Behaviour ◽

Autism Severity ◽

Cognitive Level ◽

Parental Quality ◽

Vineland Adaptive Behaviour Scales ◽

Behavioural Profile ◽

The Impact

Abstract PurposeThis study aimed to determine the association between parental quality of life (QoL) and autism severity, child’s cognitive level, adaptive behaviour and behavioural profile, and sociodemographic factors utilising the Quality of Life in Autism Questionnaire (QoLA).MethodsParents of children attending an autism specific preschool centre completed a sociodemographic questionnaire, the Quality of Life in Autism Questionnaire (QoLA), Vineland Adaptive Behaviour Scales 2nd edition (VABS) and Child Behaviour Checklist (CBCL). Trained researchers assessed autism severity with the Autism Diagnostic Observation Schedule-2 (ADOS-2) and the cognitive level with the Mullen Scales of Early Learning (MSEL).ResultsFor parents of children on the autism spectrum, having other children without the condition buffered the potential negative effects on parental QoL. Lower levels of autism severity and internalising behaviours, and higher levels of daily living scores predicted greater perceived parental QoL. Parents perceived their child’s autism-specific behaviour as less problematic when the child had higher socialisation scores. While lower levels of Attention Problems, Withdrawn Behaviour and lower scores on the Dysregulation Profile (Externalising Behaviours, Aggressive Behaviour and Anxious/Depressed) predicted greater perceived parental QoL, higher levels of Withdrawn Behaviour, Aggression and Externalising Behaviour predicted poorer perceived parental QoL. There were no significant findings for the relationship between parental QoL and cognitive level.ConclusionThe present research establishes the complex effects of raising a child on the autism spectrum on parental QoL. Findings indicate a child’s autism symptom severity, adaptive functioning and behavioural profile has greater impact on parental QoL than cognitive level.

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Cognitive and Behavioural Development of Israeli Males with Fragile X and Down Syndrome

International Journal of Behavioral Development ◽

10.1080/016502599383937 ◽

1999 ◽

Vol 23 (2) ◽

pp. 519-531 ◽

Cited By ~ 16

Author(s):

Jacob A. Burack ◽

Cory Shulman ◽

Esther Katzir ◽

Tamar Schaap ◽

Julie M. Brennan ◽

...

Keyword(s):

Down Syndrome ◽

Daily Living ◽

Fragile X ◽

Relative Strength ◽

Daily Living Skills ◽

Adaptive Behaviour ◽

Behavioural Development ◽

Homogeneous Groups ◽

Vineland Adaptive Behaviour Scales ◽

Living Skills

Hebrew translations of the Kaufman Assessment Battery for Children (KABC) and the Vineland Adaptive Behaviour Scales (VABS) were administered to 17 Israeli males with fragile X and 17 with Down syndrome matched for chronological and mental ages. When differences in the initial baselines were considered, the pattern of findings was generally consistent with previous reports. On the K-ABC, the males with fragile X scored higher on some subtests of the Simultaneous Domain but not on any of those of the Sequential Domain. On the VABS, superior scores of the males with fragile X on the Daily Living Skills and Communication domains is consistent with prior evidence of their relative strength on the former and the specific weakness of persons with Down syndrome on the latter. These differences between the males with fragile X and Down syndrome with regard to functioning on various domains and subdomains highlight the need to carefully examine the profiles of aetiologically homogeneous groups of persons.

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Detection of diarrhoea associated rotavirus and co-infection with diarrhoeagenic pathogens in the Littoral region of Cameroon using ELISA, RT-PCR and Luminex xTAG GPP assays

BMC Infectious Diseases ◽

10.1186/s12879-021-06318-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rahinatou N. Ghapoutsa ◽

Maurice Boda ◽

Rashi Gautam ◽

Valantine Ngum Ndze ◽

Akongnwi E. Mugyia ◽

...

Keyword(s):

Demographic Data ◽

Laboratory Diagnosis ◽

Epidemiological Studies ◽

Sub Saharan Africa ◽

Rt Pcr ◽

Mortality And Morbidity ◽

Vaccine Introduction ◽

Littoral Region ◽

Rotavirus Vaccines ◽

The Impact

Abstract Background Despite the global roll-out of rotavirus vaccines (RotaTeq/Rotarix / ROTAVAC/Rotasiil), mortality and morbidity due to group A rotavirus (RVA) remains high in sub-Saharan Africa, causing 104,000 deaths and 600,000 hospitalizations yearly. In Cameroon, Rotarix™ was introduced in March 2014, but, routine laboratory diagnosis of rotavirus infection is not yet a common practice, and vaccine effectiveness studies to determine the impact of vaccine introduction have not been done. Thus, studies examining RVA prevalence post vaccine introduction are needed. The study aim was to determine RVA prevalence in severe diarrhoea cases in Littoral region, Cameroon and investigate the role of other diarrheagenic pathogens in RVA-positive cases. Methods We carried out a study among hospitalized children < 5 years of age, presenting with acute gastroenteritis in selected hospitals of the Littoral region of Cameroon, from May 2015 to April 2016. Diarrheic stool samples and socio-demographic data including immunization and breastfeeding status were collected from these participating children. Samples were screened by ELISA (ProSpecT™ Rotavirus) for detection of RVA antigen and by gel-based RT-PCR for detection of the VP6 gene. Co-infection was assessed by multiplexed molecular detection of diarrheal pathogens using the Luminex xTAG GPP assay. Results The ELISA assay detected RVA antigen in 54.6% (71/130) of specimens, with 45, positive by VP6 RT-PCR and 54, positive using Luminex xTAG GPP. Luminex GPP was able to detect all 45 VP6 RT-PCR positive samples. Co-infections were found in 63.0% (34/54) of Luminex positive RVA infections, with Shigella (35.3%; 12/34) and ETEC (29.4%; 10/34) detected frequently. Of the 71 ELISA positive RVA cases, 57.8% (41/71) were fully vaccinated, receiving two doses of Rotarix. Conclusion This study provides insight on RVA prevalence in Cameroon, which could be useful for post-vaccine epidemiological studies, highlights higher than expected RVA prevalence in vaccinated children hospitalized for diarrhoea and provides the trend of RVA co-infection with other enteric pathogens. RVA genotyping is needed to determine circulating rotavirus genotypes in Cameroon, including those causing disease in vaccinated children.

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The Impact of COVID-19 on the Adaptive Functioning, Behavioral Problems, and Repetitive Behaviors of Italian Children with Autism Spectrum Disorder: An Observational Study

Children ◽

10.3390/children8020096 ◽

2021 ◽

Vol 8 (2) ◽

pp. 96

Author(s):

Martina Siracusano ◽

Eugenia Segatori ◽

Assia Riccioni ◽

Leonardo Emberti Gialloreti ◽

Paolo Curatolo ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Behavioral Problems ◽

Adaptive Functioning ◽

Children With Autism ◽

Autism Spectrum ◽

Repetitive Behaviors ◽

Assessment System ◽

Spectrum Disorder ◽

Adaptive Skills ◽

The Impact

Children with autism spectrum disorder (ASD) and their families have represented a fragile population on which the extreme circumstances of the COVID-19 outbreak may have doubly impaired. Interruption of therapeutical interventions delivered in-person and routine disruption constituted some of the main challenges they had to face. This study investigated the impact of the COVID-19 lockdown on adaptive functioning, behavioral problems, and repetitive behaviors of children with ASD. In a sample of 85 Italian ASD children (mean age 7 years old; 68 males, 17 females), through a comparison with a baseline evaluation performed during the months preceding COVID-19, we evaluated whether after the compulsory home confinement any improvement or worsening was reported by parents of ASD individuals using standardized instruments (Adaptive Behavior Assessment System (Second Edition), Achenbach Child Behavior Checklist, Repetitive Behavior Scale-Revised). No significant worsening in the adaptive functioning, problematic, and repetitive behaviors emerged after the compulsory home confinement. Within the schooler children, clinical stability was found in reference to both adaptive skills and behavioral aspects, whereas within preschoolers, a significant improvement in adaptive skills emerged and was related to the subsistence of web-delivered intervention, parental work continuance, and online support during the lockdown.

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Influenza With an Infiltrate: Investigating the New Community-Acquired Pneumonia Guidelines

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.884 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s302-s302

Author(s):

Amanda Barner ◽

Lou Ann Bruno-Murtha

Keyword(s):

Demographic Data ◽

Retrospective Chart Review ◽

Vaccination Rate ◽

Community Acquired Pneumonia ◽

Teaching Hospitals ◽

Antibiotic Prescribing ◽

Supporting Evidence ◽

Radiographic Findings ◽

Significant Difference ◽

The Impact

Background: The Infectious Diseases Society of America released updated community-acquired pneumonia (CAP) guidelines in October 2019. One of the recommendations, with a low quality of supporting evidence, is the standard administration of antibiotics in adult patients with influenza and radiographic evidence of pneumonia. Procalcitonin (PCT) is not endorsed as a strategy to withhold antibiotic therapy, but it could be used to de-escalate appropriate patients after 48–72 hours. Radiographic findings are not indicative of the etiology of pneumonia. Prescribing antibiotics for all influenza-positive patients with an infiltrate has significant implications for stewardship. Therefore, we reviewed hospitalized, influenza-positive patients at our institution during the 2018–2019 season, and we sought to assess the impact of an abnormal chest x-ray (CXR) and PCT on antibiotic prescribing and outcomes. Methods: We conducted a retrospective chart review of all influenza-positive admissions at 2 urban, community-based, teaching hospitals. Demographic data, vaccination status, PCT levels, CXR findings, and treatment regimens were reviewed. The primary outcome was the difference in receipt of antibiotics between patients with a negative (<0.25 ng/mL) and positive PCT. Secondary outcomes included the impact of CXR result on antibiotic prescribing, duration, 30-day readmission, and 90-day mortality. Results: We reviewed the medical records of 117 patients; 43 (36.7%) received antibiotics. The vaccination rate was 36.7%. Also, 11% of patients required intensive care unit (ICU) admission and 84% received antibiotics. Moreover, 109 patients had a CXR: 61 (55.9%) were negative, 29 (26.6%) indeterminate, and 19 (17.4%) positive per radiologist interpretation. Patients with a positive PCT (OR, 12.7; 95% CI, 3.43–60.98; P < .0007) and an abnormal CXR (OR, 7.4; 95% CI, 2.9–20.1; P = .000003) were more likely to receive antibiotics. There was no significant difference in 30-day readmission (11.6% vs 13.5%; OR, 0.89; 95% CI, 0.21–3.08; P = 1) and 90-day mortality (11.6% vs 5.4%; OR, 2.37; 95% CI, 0.48–12.75; P = .28) between those that received antibiotics and those that did not, respectively. Furthermore, 30 patients (62.5%) with an abnormal CXR received antibiotics and 21 (43.7%) had negative PCT. There was no difference in 30-day readmission or 90-day mortality between those that did and did not receive antibiotics. Conclusions: Utilization of PCT allowed selective prescribing of antibiotics without impacting readmission or mortality. Antibiotics should be initiated for critically ill patients and based on clinical judgement, rather than for all influenza-positive patients with CXR abnormalities.Funding: NoneDisclosures: None

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Evaluation of a Coupled Model to Predict the Impact of Adaptive Behaviour in the Thermal Sensation of Occupants of Naturally Ventilated Buildings in Warm-Humid Regions

Sustainability ◽

10.3390/su13010255 ◽

2020 ◽

Vol 13 (1) ◽

pp. 255

Author(s):

Luciano C. de Faria ◽

Marcelo A. Romero ◽

Lúcia F. S. Pirró

Keyword(s):

Computational Models ◽

Thermal Sensation ◽

Coupled Model ◽

Adaptive Behaviour ◽

Humid Climate ◽

Clothing Insulation ◽

Tropical Regions ◽

Naturally Ventilated Buildings ◽

Adaptive Behaviours ◽

The Impact

Improving indoor environment quality and making urban centres in tropical regions more sustainable has become a challenge for which computational models for the prediction of thermal sensation for naturally ventilated buildings (NVBs) have major role to play. This work performed analysis on thermal sensation for non-residential NVBs located in Brazilian tropical warm-humid climate and tested the effectiveness of suggested adaptive behaviours to mitigate warm thermal sensation. The research method utilized transient computational fluid dynamics models coupled with a dynamic model for human thermophysiology to predict thermal sensation. The calculated results were validated with comparison with benchmark values from questionnaires and from field measurements. The calculated results for dynamic thermal sensation (DTS) seven-point scale showed higher agreement with the thermal sensation vote than with the predicted mean vote. The test for the suggested adaptive behaviours considered reducing clothing insulation values from 0.18 to 0.32 clo (reducing DTS from 0.1 to 0.9), increasing the air speed in 0.9 m/s (reducing DTS from 0.1 to 0.9), and applying both suggestions together (reducing DTS from 0.1 to 1.3) for five scenarios with operative temperatures spanning 34.5–24.0 °C. Results quantified the tested adaptive behaviours’ efficiency showing applicability to improve thermal sensation from slightly-warm to neutral.

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