Tag: Family and Parenting

“Could My Child Have Autism?”

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Ten Signs of Possible Autism-Related Delays in 6- to 12-Month-Old Children

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Though autism is often not diagnosed until the age of three, some children begin to show signs of developmental delay before they turn a year old. While not all infants and toddlers with delays will develop autism spectrum disorders (ASD), experts point to early detection of these signs as key to capitalizing on early diagnosis and intervention, which is believed to improve developmental outcomes.

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According to Dr. Rebecca Landa, director of the Center for Autism and Related Disorders at the Kennedy Krieger Institute in Baltimore, Md., parents need to be empowered to identify the warning signs of ASD and other communication delays. “We want to encourage parents to become good observers of their children’s development so that they can see the earliest indicators of delays in a baby’s communication, social and motor skills,” says Dr. Landa, who also cautions that some children who develop ASD don’t show signs until after the second birthday or regress after appearing to develop typically.

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For the past decade, Dr. Landa has followed infant siblings of children with autism to identify red flags of the disorder in their earliest form. Her research has shown that diagnosis is possible in some children as young as 14 months and sparked the development of early intervention models that have been shown to improve outcomes for toddlers showing signs of ASD as young as one and two years old. Dr. Landa recommends that as parents play with their infant (6 – 12 months), they look for the following signs that have been linked to later diagnosis of ASD or other communication disorders: 1. Rarely smiles when approached by caregivers2. Rarely tries to imitate sounds and movements others make, such as smiling and laughing, during simple social exchanges3. Delayed or infrequent babbling4. Does not respond to his or her name with increasing consistency from 6 – 12 months 5. Does not gesture to communicate by 10 months6. Poor eye contact7. Seeks your attention infrequently8. Repeatedly stiffens arms, hands, legs or displays unusual body movements such as rotating the hands on the wrists, uncommon postures or other repetitive behaviors9. Does not reach up toward you when you reach to pick him or her up10. Delays in motor development, including delayed rolling over, pushing up and crawling

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“If parents suspect something is wrong with their child’s development, or that their child is losing skills, they should talk to their pediatrician or another developmental expert,” says Dr. Landa. “Don’t adopt a ‘wait and see’ perspective. We want to identify delays early in development so that intervention can begin when children’s brains are more malleable and still developing their circuitry.”

About the Kennedy Krieger Institute Internationally recognized for improving the lives of children and adolescents with disorders and injuries of the brain and spinal cord, the Kennedy Krieger Institute in Baltimore, MD serves more than 16,000 individuals each year through inpatient and outpatient clinics, home and community services and school-based programs. Kennedy Krieger provides a wide range of services for children with developmental concerns mild to severe, and is home to a team of investigators who are contributing to the understanding of how disorders develop while pioneering new interventions and earlier diagnosis. For more information on Kennedy Krieger Institute, visit: www.kennedykrieger.org.

Families of Children With Autism Face Physical, Mental and Social Burdens

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Photo by Emma Bauso on Pexels.com

Caregivers face increased social isolation and emotional burnout .

Families of children with autism face high physical, mental and emotional burdens, are sometimes ridiculed and even accused of child abuse, according to a Rutgers study.

The findings were published in the International Journal of Autism & Related Disabilities.

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The study surveyed 25 caregivers of 16 children ages 2 to 20 with autism spectrum disorder to evaluate how their care affected their family dynamics, physical and mental health, and social functioning. The researchers also asked about the caregivers’ worries, daily activities, family relationships and insurance.

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“While the understanding of how autism spectrum disorders impact individuals has grown, the awareness of the burden on families who care for these individuals is less established,” said Xue Ming, a professor of neurology at Rutgers New Jersey Medical School. “Caring for loved ones with autism spectrum disorder is emotionally and physically taxing.”

The study found:

  • Emotional burnout was more likely in families with a child with low-functioning autism spectrum disorder and simultaneous conditions.
  • Social isolation was greater in families who reported significant emotional burnout.
  • Families with more than one caregiver experienced less emotional burnout and social isolation.
  • Families with a higher socioeconomic status tended to spend more money on medical treatments outside of their health insurance policy.
  • Families with an aggressive and irritable child tended to experience more social isolation and emotional burnout.
  • Simultaneous medical and behavioral disorders were common in these children.
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Nine of the 16 families in the study reported being ridiculed or accused of child abuse, which they said limited them from attending social events, visiting public places such as churches, supermarkets and restaurants, and using mass transportation.

“This suggests that communities need to improve their inclusiveness for families with children with autism spectrum disorder,” Ming said. “The study shows there is a need to raise public awareness of the burdens faced by these families and to alert medical providers to provide them with more support.”

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The findings also can be used to advocate for better resources for these children and families to improve their quality of life and reduce stress, she said.  

Other Rutgers co-authors included Binhao Wu, Max Yang and Apoorva Polavarapu.

Children of abused mothers

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Photo by Jen Theodore

50% more likely to have low IQ

Children of women who reported domestic violence in pregnancy or during the first six years of the child’s life are almost 50% more likely to have a low IQ at age 8, research finds.

In the study by University of Manchester epidemiologists, 13% of children whose mothers did not experience domestic violence had an IQ of below 90 at 8 years of age.

If their mothers experienced physical violence from their partner either in pregnancy or during the first six years of the child’s life, the figure rises to 22.8%.

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The team led by Dr Kathryn Abel from The University of Manchester show the chance of a low IQ rises to 34.6% if the mother was repeatedly exposed to domestic violence.

That means children with mothers who repeatedly suffer domestic violence during pregnancy and the first six years of their child’s life are almost three times more likely to have a low IQ at 8 years of age, find researchers.

Low IQ is defined as an IQ score less than 90, where a normal IQ is considered to be 100.

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The study examined the link between domestic violence – also called Intimate partner violence (IPV) – and child intelligence at 8 year’s old, using 3,997 mother child pairs from The University of Bristol’s Avon Longitudinal Study of Parents and Children.

The study, funded by the Wellcome Trust and Medical Research Council, is published in Wellcome Open Research.

ALSPAC follows children from pregnancy, and measures emotional and physical domestic violence – also known as intimate partner violence – from pregnancy until eight years of age.

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The intelligence of the children was measured at eight years using the Weschler standardised IQ test.

Dr Abel said: “We already know that 1 in 4 women age 16 and over in England and Wales will experience domestic violence in their lifetime and that their children are at greater risk of physical, social and behavioural problems.

“We also know that intelligence in childhood is strongly linked with doing well in adulthood, though there has been little evidence about the risk of low IQ for these children.

“While we cannot conclude that IPV causes low IQ, these findings demonstrate domestic violence has a measurable link, by mid-childhood, independent of other risk factors for low IQ.”

17.6% of the mothers in the study reported emotional violence and 6.8% reported physical violence.

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The findings are independent of other risk factors for low IQ such as alcohol and tobacco use in pregnancy, maternal depression, low maternal education and financial hardship around the child’s birth.

There is some disagreement on whether the IQ test is a complete measure of intelligence, as it only considers verbal and non-verbal intelligence

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However, it is regarded as useful by many experts because a high IQ has been demonstrated in many countries and cultures to associate with a broad range of improved social and health outcomes.

Dr Hein Heuvelman, from The University of Bristol added: “Exposure to domestic violence is common for children in the UK and an important and often overlooked risk factor in their life chances.

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“So knowing the extent to which these already vulnerable children are further affected is a powerful argument for more, better and earlier intervention.

“Current support for women experiencing domestic violence is inadequate in some areas and absent in others.

“Early intervention with these families protects children from harm, but it may also prioritise their future development.”

Families of youth with autism face big barriers to care, gaps in services

Case Western Reserve University researchers examine needs, services for youth with autism and their family caregivers

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Photo by Tim Graf

New research at Case Western Reserve University found big gaps in services and continued care for children with autism—and their families—as they transition from adolescence to adulthood.

The families need more support, including improved job training, access to services and transportation, according to research from the university’s Jack, Joseph and Morton Mandel School of Applied Social Sciences.

Researchers surveyed 174 families from Northeast Ohio to examine the needs and barriers to services for youth with autism—from 16 to 30 years old—and their family caregivers.

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Examining the issues

Participants were recruited from  28 public and private agencies and organizations. The survey asked about services—both received and needed—as well as top concerns. Chief among them: limited access to information, reported by 51% of the respondents. Other issues include waiting lists or services not being available (44%), location (39%) and cost (37%).

Researchers also examined the quality of the services provided. They found that often families don’t know where to turn for service, or what services exist.

“The number one thing we heard from parents was that they weren’t aware of the services available to them,” said Karen Ishler, a senior research associate at the Mandel School and co-director of the project.  “How do you know what you don’t know? Who do they talk to?” 

David Biegel, the Henry L. Zucker Professor of Social Work Practice at the Mandel School and one of the project’s co-directors.  said there were some positives learned from the research, too. More than 60% said they “see eye-to-eye” with their spouse/partner regarding care, and more than 65% of the caregivers reported other positive aspects of care.

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“Autism spectrum disorder (ASD) affects the entire family,” said Biegel, “Many young people with ASD are at risk for reduced quality of life in adulthood. Additionally, families of adolescents and young adults with ASD face all kinds of stressors—especially during those critical transition years.”

Take, for example, finding a job. Children with autism are allowed to stay in public schools until age 22. When they finish, though, employment training and support dries up, according to the study.

“What happens when they age out? It’s a growing concern,” Ishler said. “We have to look at the service delivery, because we know there are many unmet needs.”

A growing concern

In 2018, Centers for Disease Control and Prevention (CDC) reported an increase in autism’s estimated prevalence in children, based on an analysis of 2014 medical and educational records of 8-year-old children nationally.

In 2004, one in 166 children nationally were diagnosed with autism; in 2018, that ratio was one in 59.

“A lot of these kids diagnosed at 4, 5 and 6 years old are now becoming young adults,” Biegel said. “It’s putting new pressures on them, and particularly their families, as they age out of school-based services.”

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One caregiver’s response about his or her daughter summed up the problem: “Don’t assume that just because she is highly intellectually functioning that she doesn’t need support and acceptance socially.”

Biegel and Ishler found that 82% of those with autism live with their parents into adulthood. “This confirms what we already know: families shoulder the burden of autism,” Biegel said. The study found that 28% family members had elevated anxiety and 35% had elevated symptoms of depression. 

“We tend to emphasize the people who aren’t doing well,” he said. “We knew there were going to be issues. But some  families are doing just fine—they’ve figured out how to navigate the system. However, here is also a significant number of families that have major concerns and needs. Our hope is that these results stimulates discussion and awareness.”

The study was funded by the International Center for Autism Research and Education (ICARE) through a Mt. Sinai Foundation catalytic grant.

Protecting kids from risky drinking

Alcoholism: Clinical & Experimental Research

Photo by Felipe Ponce
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Many parents permit their adolescent children to drink alcohol, believing this helps teach them responsible use and avoids the appeal of ‘forbidden fruit’. In research studies, greater parental permissibility for alcohol has been linked to earlier and heavier drinking in adolescence. However, it is not clear whether parents allowing adolescents to drink is itself to blame, or if this kind of permissibility is simply a marker for other factors (relating to the family, parents or child) that increase the risk of problem alcohol use among adolescents. For example, parents’ own heavy drinking, family sociodemographics, and adolescents’ friends’ use of alcohol can all affect the likelihood of alcohol misuse among adolescents, and each of these risk factors might also be underlying causes of parents allowing drinking. In a new report published in the journal Alcoholism: Clinical & Experimental Research, researchers from Pennsylvania State University have used intergenerational data from a contemporary UK study to examine whether parents allowing adolescents to drink is itself associated with risky drinking in adolescence, beyond other such risk factors.

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The Millennium Cohort Study (MCS) has collected data from over eleven thousand parents and children from infancy through to 14 years, using regular interviews. Children were asked questions about their alcohol use when they were aged 11 and 14 years; the data showed that by age 14, half had drunk more than a few sips of alcohol, around 10% had drunk heavily, and 3% had drunk heavily at least 3 times in the past year. Seven percent had made a rapid transition to heavy drinking, defined as escalating to having at least five drinks at a time, within a year of having their first drink.  

Parents of 14-year olds were asked if they permitted their child to use alcohol, with about 16% of parents indicating that they did allow this. Using a series of statistical analyses, the researchers found that these teenagers faced an elevated risk of heavy alcohol use at age 14, even after accounting for a large host of other risk factors measured earlier when children were age 11. Specifically, children who were permitted to drink alcohol had over twice the odds of engaging in heavy or frequent heavy drinking by age 14, and almost double the risk of a rapid transition to heavy drinking, than those whose parents did not permit alcohol use.

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These findings do not support the idea that allowing children to drink alcohol inoculates them against alcohol misuse, and will help to target prevention and screening efforts to reduce underage drinking. However, the researchers note that because adolescent heavy drinking and parental permissiveness about alcohol were measured at the same point in the survey (at around age 14), the findings represent an association rather than cause and effect; further research will be needed to establish whether parental permissiveness leads to adolescent heavy drinking, or whether adolescent drinking over time leads parents to become more permissive.

Parents Allowing Drinking is Associated with Adolescents’ Heavy Alcohol Use. J. Staff, J. Maggs (pages xxx).

ACER-19-4039.R1

A sensor to save children and pets left in vehicles

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Credit: University of Waterloo

Graduate students Mostafa Alizadeh, left, and Hajar Abedi position a doll, modified to simulate breathing, in a minivan during testing of a new sensor.

A small, inexpensive sensor could save lives by triggering an alarm when children or pets are left alone in vehicles.

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The new device, developed by researchers at the University of Waterloo, combines radar technology with artificial intelligence (AI) to detect unattended children or animals with 100-per-cent accuracy.

Small enough to fit in the palm of a hand at just three centimetres in diameter, the device is designed to be attached to a vehicle’s rear-view mirror or mounted on the ceiling.

It sends out radar signals that are reflected back by people, animals and objects in the vehicle. Built-in AI then analyzes the reflected signals.

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“It addresses a serious, world-wide problem,” said George Shaker, an engineering professor at Waterloo. his system is so affordable it could become standard equipment in all vehicles.”

Development of the wireless, disc-shaped sensor was funded in part by a major automotive parts manufacturer that is aiming to bring it to market by the end of 2020.

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Analysis by the device determines the number of occupants and their locations in a vehicle. That information could be used to set rates for ride-sharing services and toll roads, or to qualify vehicles for car-pool lanes.

Its primary purpose, however, is to detect when a child or pet has been accidentally or deliberately left behind, a scenario that can result in serious harm or death in extremely hot or cold weather.

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In such cases, the system would prevent vehicle doors from locking and sound an alarm to alert the driver, passengers and other people in the area that there is a problem.

“Unlike cameras, this device preserves privacy and it doesn’t have any blind spots because radar can penetrate seats, for instance, to determine if there is an infant in a rear-facing car seat,” said Shaker, a cross-appointed professor of electrical and computer engineering, and mechanical and mechatronics engineering.

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The low-power device, which runs on a vehicle’s battery, distinguishes between living beings and inanimate objects by detecting subtle breathing movements.

Researchers are now exploring the use of that capability to monitor the vital signs of drivers for indications of fatigue, distraction, impairment, illness or other issues.

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Shaker supervised graduate students Mostafa Alizadeh and Hajar Abedi on the research.

A paper on their project, Low-cost low-power in-vehicle occupant detection with mm-wave FMCW radar, was recently presented at an international conference in Montreal.