General Measurement Tools for Assessing Mental Health Problems Among Children and Adolescents with an Intellectual Disability: A Systematic Review

There is a need for more knowledge of valid and standardized measures of mental health problems among children and adolescents with intellectual disability (ID). In this study, we systematically reviewed and evaluated the psychometric properties of instruments used to assess general mental health problems in this population. Following PRISMA guidelines, we reviewed empirical research published from 1980 through February 2020 with an updated search in March 2021 in Medline, Embase, PsycINFO, Health and Psychological Instruments, CINAHL, ERIC, and Web of Science databases. Forty-nine empirical articles were included in this review. Overall, the review indicated consistently better documentation of the reliability and validity of instruments designed for the ID population compared to instruments developed for the general child population.

Feasibility of a virtual reality-based exercise intervention and low-cost motion tracking method for estimation of motor proficiency in youth with autism spectrum disorder

Background Motor impairment is widely acknowledged as a core feature in children with autism spectrum disorder (ASD), which can affect adaptive behavior and increase severity of symptoms. Low-cost motion capture and virtual reality (VR) game technologies hold a great deal of promise for providing personalized approaches to motor intervention in ASD. The present study explored the feasibility, acceptability and potential efficacy of a custom-designed VR game-based intervention (GaitWayXR™) for improving gross motor skills in youth with ASD. Methods Ten children and adolescents (10–17 years) completed six, 20-min VR-based motor training sessions over 2 weeks while whole-body movement was tracked with a low-cost motion capture system. We developed a methodology for using motion tracking data to quantify whole-body movement in terms of efficiency, synchrony and symmetry. We then studied the relationships of the above quantities with standardized measures of motor skill and cognitive flexibility. Results Our results supported our presumption that the VR intervention is safe, with no adverse events and very few minor to moderate side-effects, while a large proportion of parents said they would use the VR game at home, the most prohibitive reasons for adopting the system for home therapy were cost and space. Although there was little evidence of any benefits of the GaitWayXR™ intervention in improving gross motor skills, we showed several positive correlations between the standardized measures of gross motor skills in ASD and our measures of efficiency, symmetry and synchrony from low-cost motion capture. Conclusions These findings, though preliminary and limited by small sample size, suggest that low-cost motion capture of children with ASD is feasible with movement exercises in a VR-based game environment. Based on these preliminary findings, we recommend conducting larger-scale studies with methods for improving adherence to VR gaming interventions over longer periods.

Assessing Spoken Language Development in Children with Autism Spectrum Disorder

In this chapter, the author discusses assessment of language development in children with autism spectrum disorder (ASD). According to evidence-based practice, it is vital to evaluate all aspects of communication in order to determine a specific diagnosis or to direct intervention. While this is true for any child suspected of having a language impairment, it is especially true for children also diagnosed with ASD. Although there are a number of accepted standardized measures to evaluate receptive and expressive language and speech articulation, evaluation of pragmatic abilities is often more complicated. With the incidence of children and young adults with ASD, and social (pragmatic) communication disorders, on the rise in all settings, it is vital to thoughtfully consider best practice related to the thorough assessment of communication abilities for those with ASD, from our youngest learners to adolescents.

Comparison of Educationally Labeled and Nonlabeled Adolescents With Emotional and Behavioral Needs

Epidemiologic research suggests a gap between prevalence estimates of students with emotional or behavioral problems and the actual number of students identified under the federal category of emotional disturbance (ED). To better understand issues related to the identification gap, we investigated the academic and behavioral functioning, school-based services, frequency of discipline incidents, and predictors of labels among 626 secondary age students referred for participation in a larger study due to emotional and behavioral difficulties. Students with special education labels (i.e., ED, specific learning disability [SLD], other health impairment [OHI]) were compared to those who did not have a school label. Analyses indicated that there were no significant differences between groups on standardized measures of emotional and behavioral functioning. Academic performance was the only distinction, with students with learning disabilities scoring significantly lower in reading and math than students with other and without disabilities. Students without an ED label received significantly fewer services whereas students with an ED label received significantly higher rates of disciplinary actions. Finally, demographic data examined did not differentially predict receipt of a label.

Interpreting a standardized and normalized measure of neighborhood socioeconomic status for a better understanding of health differences

Background Standardization and normalization of continuous covariates are used to ease the interpretation of regression coefficients. Although these scaling techniques serve different purposes, they are sometimes used interchangeably or confused for one another. Therefore, the objective of this study is to demonstrate how these scaling techniques lead to different interpretations of the regression coefficient in multilevel logistic regression analyses. Methods Area-based socioeconomic data at the census tract level were obtained from the 2015–2019 American Community Survey for creating two measures of neighborhood socioeconomic status (SES), and a hypothetical data on health condition (favorable versus unfavorable) was constructed to represent 3000 individuals living across 300 census tracts (i.e., neighborhoods). Two measures of neighborhood SES were standardized by subtracting its mean and dividing by its standard deviation (SD) or by dividing by its interquartile range (IQR), and were normalized into a range between 0 and 1. Then, four separate multilevel logistic regression analyses were conducted to assess the association between neighborhood SES and health condition. Results Based on standardized measures, the odds of having unfavorable health condition was roughly 1.34 times higher for a one-SD change or a one-IQR change in neighborhood SES; these reflect a health difference of individuals living in relatively high SES (relatively affluent) neighborhoods and those living in relatively low SES (relatively deprived) neighborhoods. On the other hand, when these standardized measures were replaced by its respective normalized measures, the odds of having unfavorable health condition was roughly 3.48 times higher for a full unit change in neighborhood SES; these reflect a health difference of individuals living in highest SES (most affluent) neighborhoods and those living in lowest SES (most deprived) neighborhoods. Conclusion Multilevel logistic regression analyses using standardized and normalized measures of neighborhood SES lead to different interpretations of the effect of neighborhood SES on health. Since both measures are valuable in their own right, interpreting a standardized and normalized measure of neighborhood SES will allow us to gain a more rounded view of the health differences of individuals along the gradient of neighborhood SES in a certain geographic location as well as across different geographic locations.

Spiritual Support Among African American and Caucasian ADRD Caregivers: A Risk and Resilience Study

Research shows African Americans at greater risk of developing Alzheimer’s disease and related dementias (ADRD) compared to Caucasians, suggesting African American ADRD caregivers are rising in numbers at a greater rate than Caucasian counterparts. A recent study indicated spiritual wellbeing differences among these caregiver groups. Using a quasi-follow-up of members of a larger caregiver sample, the purpose of this study was to test spiritual support as a moderator via a risk-and-resilience framework. Secondary data analysis from a sample of 691 ADRD caregivers examined data on demographics and standardized measures of spiritual support, caregiver burden, and psychological resilience. One-third of the sample reported as African American. Resilience negatively regressed, though not significantly, on caregiving burden among both groups. Spiritual support positively, significantly impacted resilience among both groups, slightly stronger among African Americans. Spiritual support did not significantly moderate risk with either group. Implications for professional healthcare practice are discussed.

8-Year Changes in Frailty in Adults: Links to Cognitive and Physical Function and Mortality

Deficit accumulation frailty indices are being evaluated as clinical markers of biological aging. In this context, it is to be expected that changes over time in such indices should be predictive of downstream changes in cognition, physical function, and mortality. We derived a frailty index (FI) based on deficit accumulation in 38 functional, behavioral, and clinical characteristics and examined associations between 8-year changes in FI and subsequent standardized measures of cognitive and physical function and mortality collected over years 8-18. We drew data from the Look AHEAD clinical trial of a multidomain intensive lifestyle intervention (ILI) in 3841 adults, aged 45-76 years at baseline with overweight/obesity and type 2 diabetes mellitus. Greater FI increases tended to occur among individuals who were older, non-Hispanic White, heavier, and who had greater baseline multimorbidity. Greater increases in FI were associated with subsequently worse levels of composite cognitive function and 400m walk speed (all p<0.001). Additionally, compared with the lowest tertile of FI change, hazard ratios [95% confidence intervals] for 10-year mortality for the middle and highest tertiles of FI change were 1.28 [1.03.1.58] and 1.56 [1.24,1.96], respectively. While assignment to ILI was associated with smaller 8-year increases in FI, this did not translate overall to better cognitive functioning compared to the Diabetes Support and Education control condition across years 8-18. Increase in FI over 8 years predicts subsequent reduced function and greater mortality. However, whether interventions generally targeting FI reduce risks for downstream outcomes remains to be seen.

O papel da inflexibilidade psicológica na relação entre o stress relacionado com a infertilidade e os sintomas depressivos em mulheres com um diagnóstico de infertilidade

Background and Aim: Introduction: Infertility is a medical and social condition that impacts people’s lives at the marital, family, social and financial levels. Several studies point to comorbidity between psychopathology and infertility, and people facing the demands of infertility may use maladaptive mechanisms of emotion regulation translated into psychological inflexibility. Objectives: This current study aimed to explore the mediating role of infertility-related psychological inflexibility in the relationship between infertility-related stress and depressive symptoms in women presenting an infertility diagnosis and pursuing infertility medical treatment. In addition, as a secondary aim, the associations between the time since diagnosis and the study variables were examined. Methods: A cross-sectional study was conducted on a sample of 96 women recruited with the support of the Portuguese Fertility Association. Participants filled in online a set of self-report instruments. Sociodemographic and clinical data were collected, and standardized measures of infertility-related stress, depressive symptoms, and infertility-related psychological inflexibility were used. Results: The results demonstrated that the effect of infertility-related stress on depressive symptoms was .46, being totally mediated by infertility-related psychological inflexibility. Discussion: Difficulty in achieving a pregnancy is a painful life event that interferes with the goals and plans for building a family, which can lead to stress and depressive symptoms. The relationship between these symptoms seems to be influenced by the mechanism of infertility-related psychological inflexibility. Therefore, interventions such as Acceptance and Commitment Therapy and the Mindfulness-Based Program for Infertility may be particularly suitable for this population by integrating psychological inflexibility as a therapeutic target.

Bullying Victimization Among Ukrainian College Students: The Role of Family Communication and Satisfaction, Corporal Punishment and Child Abuse

Bullying involves aggression that is proactive, intentional, and repeated in a relationship with unequal power. We assessed the association of recent bullying victimization with family processes during childhood using standardized measures in a sample of 1008 young adults attending 10 Ukrainian universities in Ukraine. Structural equation modeling was utilized to examine the associations between family communication and satisfaction, childhood corporal punishment and abuse, and adulthood bullying victimization. The majority of participants had been bullied by a peer or teacher (62.38%) and had a history of corporal punishment (63.46%). There were direct effects of child abuse and corporal punishment and family communication style on bullying victimization during young adulthood. The extent of satisfaction with students’ families of origin showed indirect effects. The results highlight the present needs of many students, as well as the risk factors associated with bullying victimization during their post-secondary education years.

Scoping Review of Interventions for Individuals with Autism Spectrum Disorders in Low-and-Middle-Income Countries

Although an increased number of autism interventions have been introduced from high-income countries (HICs) to low-and-middle-income countries (LMICs), research exists to show that interventions validated as effective in HICs are not equally effective in LMICs. The lack of an overview of autism interventions from LMICs presents a knowledge barrier to well-informed implementation of autism interventions in LMICs’ contexts. This scoping review sought to answer: (a) what autism interventions have been reported in LMICs? and (b) how those interventions were adopted to tailor LMICs’ contexts? Twenty intervention studies were included for review. Results revealed that 12 of 20 interventions were originally developed in HICs. The interventions reported across LMICs presented a recognizable profile similar to those in HICs concerning (a) the dominance of mothers’ involvement in parent-implemented interventions, (b) a preponderance of social communication and behavioral interventions, and (c) the use of prevalent standardized measures developed in the HICs. The included interventions were delivered across Africa, Asia, and Eastern Europe with various degrees of adaptions made in (a) intervention content and context, (b) assessment of participant eligibility, and (c) outcome measures. Implications for capacity building in autism interventions across LMICs, were discussed thereafter.