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Mayer Y, Cohen-Eilig M, Chan J, Kuzyk N, Glodjo A, Jarus T. Digital citizenship of children and youth with autism: Developing guidelines and strategies for caregivers and clinicians to support healthy use of screens. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1010-1028. [PMID: 37615409 PMCID: PMC10981179 DOI: 10.1177/13623613231192870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
LAY ABSTRACT Children and youth with autism use screens in their daily lives and in their rehabilitation programs. Although parents and clinicians experience specific challenges when supporting positive screen time use of children and youth with autism, no detailed information for this group exists. Therefore, this study aimed to develop clear guidelines that are agreed by expert clinicians and parents of children and youth with autism. Using a method called Delphi, 30 experts-20 clinicians and 10 caregivers, who have experience working with or caring for children and youth with autism were invited to complete a series of three surveys. In each round, the experts had to rate their agreement with statements regarding screen time management. The agreement level was set to 75%. The final themes to be included in the guidelines were accepted by more than 75% of the panel. The final guidelines included six main sections: (1) general principles, (2) considerations for timing and content of leisure screen time use, (3) strategies for caregivers and clinicians to monitor and regulate screen time use, (4) behaviors to monitor for screen time overuse, (5) additional guidelines for clinicians, and (6) resources. The new guidelines developed in this study can provide potential guidance on how to further the development of digital citizenship for children and youth with autism and provide strategies to families to help manage screen time use.
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Affiliation(s)
- Yael Mayer
- University of Haifa, Israel
- The University of British Columbia, Canada
| | | | | | | | | | - Tal Jarus
- The University of British Columbia, Canada
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Bodde AE, White DA, Forseth B, Hastert M, Washburn R, Donnelly J, Sullivan D, Ptomey LT. Parent factors associated with BMI, diet, and physical activity of adolescents with intellectual and developmental disabilities. Disabil Health J 2023; 16:101507. [PMID: 37487764 DOI: 10.1016/j.dhjo.2023.101507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/27/2023] [Accepted: 07/03/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Adolescents with intellectual and developmental disabilities (IDD) experience overweight and obesity (OW/OB) up to 1.8 times the rate of their typically developing peers. Parents may influence adolescent weight management behaviors in this population, but the association between parent factors and adolescent weight management behaviors is unclear. OBJECTIVE To examine the associations between parent BMI and sociodemographic characteristics with adolescents' BMI, diet quality, daily energy intake, moderate to vigorous physical activity (MVPA), and sedentary behavior. METHODS This study analyzed baseline data from an 18-month randomized controlled weight loss trial for adolescents with IDD. We assessed parent BMI (kg/m2) and sociodemographic factors, and adolescent BMI z-score, MVPA, sedentary time, daily energy intake, and diet quality. Associations between parent and adolescent factors were assessed with Pearson, Spearman or Kendall Tau-b correlations; mean differences for categorical outcomes were assessed with independent samples t-tests/Mann-Whitney U tests or ANOVA/Kruskall-Wallis tests. RESULTS Ninety-five adolescent and parent dyads were included. Parent BMI was positively correlated with adolescent BMI z-score (n = 94: rs = 0.37, p < 0.01). Household income was inversely correlated with adolescent BMI z-score (n = 95: Tb = -0.18, p = 0.02). Parents with less than a bachelor's degree had adolescents with higher BMI z-scores than those with bachelor's or higher (2.1 ± 0.5 vs. 1.8 ± 0.5, p = 0.02) as well as higher sedentary behavior (n = 28, 515.2 ± 102.6 min/day vs. n = 40, 463.9 ± 148.1 min/day, p = 0.02). CONCLUSION We found parent BMI, income, and education associated with adolescent BMI z-score. These findings contribute to the sparse literature on parental factors associated with OW/OB in this population. CLINICAL TRIALS NUMBER NCT02561754.
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Affiliation(s)
- Amy E Bodde
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.
| | - David A White
- Ward Family Heart Center, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA; School of Medicine, University of Missouri Kansas City, Kansas City, MO, USA
| | - Bethany Forseth
- Department of Physical Therapy and Rehabilitation Science, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Mary Hastert
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA; Department of Physical Therapy and Rehabilitation Science, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Richard Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Joseph Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Debra Sullivan
- Department of Dietetics and Nutrition, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Lauren T Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
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Hatfield DP, Must A, Kennedy W, Staiano AE, Slavet J, Sabelli RA, Curtin C, Bandini LG, Nauta P, Stuetzle C, Bowling AB. GamerFit-ASD beta test: adapting an evidence-based exergaming and telehealth coaching intervention for autistic youth. Front Pediatr 2023; 11:1198000. [PMID: 37732006 PMCID: PMC10507699 DOI: 10.3389/fped.2023.1198000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023] Open
Abstract
Background Health disparities faced by autistic youth are exacerbated by inadequate physical activity (PA) and sleep, whereas healthy PA and sleep may improve mood and function. Adaptive Game Squad (AGS) is an evidence-based telehealth coaching and exergaming intervention to improve PA and sleep for adolescents with diverse neurodevelopmental and psychiatric conditions. This study aimed to adapt AGS for autistic youth ages 10-15 years; beta-test the modified intervention for feasibility, accessibility, and engagement; and further refine the intervention for a larger planned demonstration pilot. Methods Interdisciplinary experts adapted AGS to create GamerFit-ASD, a 12-week intervention that included a progressive exergame schedule, Fitbit step-tracking, weekly health coaching, and health tip/exercise videos. For beta testing, the intervention was shortened to a 4-week trial with 5 parent/child dyads. Children completed exit surveys and parents and children were interviewed about intervention feasibility, accessibility, and engagement. Exit survey data were summarized with descriptive statistics. Qualitative data were analyzed using a modified grounded-theory approach. Results All participants (n = 5; ages 10-14 years) attended all 4 planned coaching sessions and completed an average of 9 of 12 planned exergame challenges for a weekly average of 50 min. All participants reported enjoying coaching sessions, 4 of 5 reported enjoying exergames, and 3 of 5 reported enjoying on-demand exercise videos. In interviews, children generally reported finding participation feasible, exergaming challenges active and fun, and coaches friendly and helpful. Parents reported high feasibility of supporting their children's involvement and valued child goal-setting and intervention flexibility; however, some found telehealth sessions overly scripted. Several adaptations to coaching scripts, coach training, and parent materials were made for the larger demonstration pilot, including changes to reduce scriptedness of coaching sessions, to provide parents with more information specific to autism, and to make video content more appropriate to children's needs/preferences. Discussion A telehealth coaching and exergaming intervention appears feasible, accessible, and engaging for autistic youth aged 10-15. Future studies with larger, more diverse samples, longer study durations and/or follow-up periods, and more rigorous study designs are needed to advance understanding of the appropriateness and effectiveness of this type of intervention for this population.
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Affiliation(s)
- Daniel P. Hatfield
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Aviva Must
- Department of Public Health and Community Medicine, Tufts University, Boston, MA, United States
| | - Winston Kennedy
- Department of Nutrition and Public Health, School of Nursing and Health Sciences, Merrimack College, North Andover, MA, United States
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Amanda E. Staiano
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - James Slavet
- Marblehead Family Therapy and Wellness, Marblehead, MA, United States
| | - Rachael A. Sabelli
- Department of Public Health and Community Medicine, Tufts University, Boston, MA, United States
| | - Carol Curtin
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Linda G. Bandini
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Phillip Nauta
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Christopher Stuetzle
- Department of Computer and Data Sciences, School of Science and Engineering, Merrimack College, North Andover, MA, United States
| | - April B. Bowling
- Department of Nutrition and Public Health, School of Nursing and Health Sciences, Merrimack College, North Andover, MA, United States
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
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Blaine RE, Blaine KP, Cheng K, Banuelos C, Leal A. Priorities, barriers, and facilitators for nutrition-related care for autistic children: a qualitative study comparing interdisciplinary health professional and parent perspectives. Front Pediatr 2023; 11:1198177. [PMID: 37650046 PMCID: PMC10465129 DOI: 10.3389/fped.2023.1198177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/27/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Children with autism spectrum disorder often face nutrition-related challenges, such as food selectivity, gastrointestinal issues, overweight and obesity, and inadequate nutrient intake. However, the role of routine nutrition-related screening or care by interdisciplinary health professionals is not well understood. This study aimed to compare the beliefs of health professionals with those of parents of autistic children regarding high-priority nutrition-related challenges, barriers and facilitators to care, and desired education and resources related to nutrition for autistic children. Participants Interdisciplinary health professionals (n = 25) (i.e., pediatricians, occupational therapists, speech-language pathologists, board certified behavior analysts, registered dietitians) and parents of autistic children (n = 22). Methods The study used semi-structured phone interviews, which were recorded, transcribed, verified, and double-coded using the Framework Method. Results Thematic analysis of transcripts revealed that while health professionals and parents of autistic children shared some perspectives on nutrition-related challenges and care, they also had distinct viewpoints. Parents emphasized the importance of addressing food selectivity, behavioral eating challenges, sensory issues, and sleep disturbances affecting appetite. Both groups acknowledged the need for tailored support, access to an interdisciplinary care team, and reasonable expectations. Some health professionals perceived parents as lacking motivation or the ability to make changes. In contrast, many parents felt that health professionals lacked the knowledge and motivation to take nutrition or growth concerns seriously. Health professionals acknowledged that their lack of knowledge or capacity to provide nutrition education or referrals was a common barrier to care, particularly given limited community resources. Discussion Health professionals who serve autistic children are motivated to address nutrition-related challenges but lack resources related to nutrition. To promote better health outcomes for autistic children, professionals should identify and support parent motivations around nutrition-related care. Both groups expressed interest in accessing autism-specific resources for education, referral, and screening guidance. Future research could explore the development of healthcare training models that improve the competency of health professionals in providing nutrition care and referral for autistic children.
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Affiliation(s)
- Rachel E. Blaine
- Department of Family and Consumer Sciences, California State University, Long Beach, CA, United States
| | - Kevin P. Blaine
- Research Institute, Children’s Hospital of Orange County, Orange, CA, United States
| | - Katie Cheng
- Department of Family and Consumer Sciences, California State University, Long Beach, CA, United States
| | - Cynthia Banuelos
- Department of Family and Consumer Sciences, California State University, Long Beach, CA, United States
| | - Aaron Leal
- Department of Family and Consumer Sciences, California State University, Long Beach, CA, United States
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van Tetering EMA, Muskens JB, Deenik J, Pillen S, Cahn W, von Rosenstiel I, Oomen M, Rommelse NN, Staal WG, Klip H. The short and long-term effects of a lifestyle intervention in children with mental illnesses: a randomized controlled trial (Movementss study). BMC Psychiatry 2023; 23:529. [PMID: 37480007 PMCID: PMC10362712 DOI: 10.1186/s12888-023-04884-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 05/17/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND A lifestyle including poor diet, physical inactivity, excessive gaming and inadequate sleep hygiene is frequently seen among Dutch children. These lifestyle behaviors can cause long-term health problems later in life. Unhealthy lifestyle and poor physical health are even more prevalent among children with mental illness (MI) such as autism, attention-deficit/hyperactivity disorder, depression, and anxiety. However, research on lifestyle interventions among children with MI is lacking. As a result, there are currently no guidelines, or treatment programs where children with MI and poor lifestyle can receive effective support. To address these issues and to provide insight into the effectiveness of lifestyle interventions in children with MI and their families, the Movementss study was designed. This paper describes the rationale, study design, and methods of an ongoing randomized controlled trial (RCT) comparing the short-term (12 weeks) and long-term (1 year) effects of a lifestyle intervention with care as usual (CAU) in children with MI and an unhealthy lifestyle. METHODS A total of 80 children (6-12 years) with MI according to DSM-V and an unhealthy lifestyle are randomized to the lifestyle intervention group or CAU at a specialized child and adolescent mental hospital. The primary outcome measure is quality of life measured with the KIDSCREEN. Secondary outcomes include emotional and behavior symptoms, lifestyle parameters regarding diet, physical activity, sleep, and screen time, cognitive assessment (intelligence and executive functions), physical measurements (e.g., BMI), parenting styles, and family functioning, prior beliefs, adherence, satisfaction, and cost-effectiveness. Assessments will take place at the start of the study (T0), after 12 weeks (T1), six months (T2), and 12 months of baseline (T3) to measure long-term effects. DISCUSSION This RCT will likely contribute to the currently lacking knowledge on lifestyle interventions in children with MI. TRIAL REGISTRATION trialsearch.who.int/ NL9822. Registered at November 2nd, 2021.
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Affiliation(s)
- Emilie M A van Tetering
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands.
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands.
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Jet B Muskens
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jeroen Deenik
- GGz Centraal, Department of Science, Amersfoort, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Sigrid Pillen
- Kinderslaapexpert BV (Pediatric Sleep Expert Ltd), Mook, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | | | - Nanda N Rommelse
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Wouter G Staal
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Leiden Institution for Brain and Cognition, Leiden, The Netherlands
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
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Ricketts EJ, Wolicki SB, Holbrook JR, Rozenman M, McGuire JF, Charania SN, Piacentini J, Mink JW, Walkup JT, Woods DW, Claussen AH. Clinical Characteristics of Children With Tourette Syndrome With and Without Sleep Disorder. Pediatr Neurol 2023; 141:18-24. [PMID: 36736236 PMCID: PMC10590926 DOI: 10.1016/j.pediatrneurol.2022.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/22/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Sleep problems are common in children with Tourette Syndrome (TS). However, research regarding their demographic and clinical profile is limited. METHODS We examined characteristics of 114 children aged five to 17 years with a lifetime diagnosis of TS and compared children with sleep disorder (n = 32) and without sleep disorder (n = 82). Parent report from the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome provided demographics and clinical information, other diagnosed disorders, medication use, TS severity, and impairment. RESULTS More children with TS with sleep disorder were from households with lower parental education (P < 0.01) and poverty (P = 0.04); had other diagnoses (P = 0.03), including obsessive-compulsive disorder (P < 0.01), oppositional defiant disorder or conduct disorder (P < 0.01), attention-deficit/hyperactivity disorder (ADHD) (P = 0.02), and autism (P = 0.03); and had ever used TS medication (P = 0.01) than children with TS without sleep disorder. More children with TS with sleep disorder had severe TS symptoms (P <0.01), tic-related impairment (P<0.01), and severe ADHD symptoms (P < 0.01) compared with children with TS without sleep disorder. CONCLUSIONS Findings suggest greater parent-reported impact and tic-related interference in children with TS with sleep disorder compared with TS without sleep disorder. Results underscore the importance of monitoring and intervention for TS exacerbations, other diagnosed disorders, and medication use, and consideration of socioeconomic context in sleep disorder management and prevention in children with TS.
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Affiliation(s)
- Emily J Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California.
| | - Sara Beth Wolicki
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joseph R Holbrook
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Joseph F McGuire
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sana N Charania
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Jonathan W Mink
- Department of Neurology, University of Rochester Medical Center, Rochester, New York
| | - John T Walkup
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Douglas W Woods
- Department of Psychology, Marquette University, Milwaukee, Wisconsin
| | - Angelika H Claussen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Lussier-Desrochers D, Massé L, Simonato I, Lachapelle Y, Godin-Tremblay V, Lemieux A. Evaluation of the Effect of a Serious Game on the Performance of Daily Routines by Autistic and ADHD Children. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2023; 7:1-13. [PMID: 36777795 PMCID: PMC9896450 DOI: 10.1007/s41252-023-00319-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
Objectives Learning and performing new routines are difficult for children with neurodevelopmental disorders. Studies have shown that consistency in child reinforcement and parental support are effective. For example, digital solutions such as serious games can be used to support parents and children in developing these life skills. The objective of this study was to evaluate the effect of a serious game on the performance of daily routines by autistic and ADHD children. Methods A total of 201 families (parents and children) participated in the study. The study used a combined 3 (intervention) × 3 (diagnosis) × 3 (time) research design with repeated measures. Participants were randomly assigned to three intervention groups (serious game, parental support, and a combination of serious game and parental support) based on their diagnosis (ASD, ADHD, neurotypical). Latent growth modeling and repeated ANOVAS were performed to analyze routine scores collected at three moments (baseline, midpoint, persistence) over an 8-week period. Results Results show a moderating effect of diagnosis on child routine trajectory. For ADHD participants, we observed a very important significant clinical effect for two interventions (parental support alone and combination of serious game and parental support) where for ASD children, this effect is observed for only one treatment (combination of serious game and parental support). For neurotypical children, results indicate a very important and significant clinical effect when they use the serious game alone. Conclusions Results show that the serious game can improve children's routines. However, for some neurodevelopmental profiles (ASD or ADHD), the addition of parental support produces greater clinical improvements.
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Affiliation(s)
- Dany Lussier-Desrochers
- Department of Psychoeducation, Université du Québec à Trois-Rivières, 3351 boulevard des Forges, Trois-Rivières, Québec, G8Z 4M3 Canada
| | - Line Massé
- Department of Psychoeducation, Université du Québec à Trois-Rivières, 3351 boulevard des Forges, Trois-Rivières, Québec, G8Z 4M3 Canada
| | - Isabelle Simonato
- Department of Psychoeducation, Université du Québec à Trois-Rivières, 3351 boulevard des Forges, Trois-Rivières, Québec, G8Z 4M3 Canada
| | - Yves Lachapelle
- Department of Psychoeducation, Université du Québec à Trois-Rivières, 3351 boulevard des Forges, Trois-Rivières, Québec, G8Z 4M3 Canada
| | - Valérie Godin-Tremblay
- Centre on Psychosocial Intervention at the Integrated University Health and Social Services Centre (CIUSSS) in Saguenay–Lac-Saint-Jean, Québec, Canada
| | - Annie Lemieux
- Department of Psychoeducation, Université du Québec à Trois-Rivières, 3351 boulevard des Forges, Trois-Rivières, Québec, G8Z 4M3 Canada
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Polfuss M, Liu T, Smith K, Murphy PS, Ward E, Thibadeau J, Dosa NP, Wang Y, Sawin KJ. Weight Status of Children Participating in the National Spina Bifida Patient Registry. Pediatrics 2022; 150:e2022057007. [PMID: 36416007 PMCID: PMC11037268 DOI: 10.1542/peds.2022-057007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Describe the distribution of weight status categories and determine factors associated with overweight and obesity (OW/OB) in children and adolescents with spina bifida (SB) using the National Spina Bifida Patient Registry. METHODS Demographic, anthropometric, and clinical data collected from 2009 through 2018 was used to describe the prevalence of OW/OB. The generalized estimating equation model (GEE) identified factors associated with OW/OB among individuals with SB. RESULTS Participants (n = 7215) were aged 2 to 19 years (mean = 11.1; standard error, 0.06) and 51.4% female. The majority were non-Hispanic white (57.2%) followed by Hispanic or Latino (25.1%) and non-Hispanic Black (7.5%). The myelomeningocele (MMC) subgroup accounted for 76.3%. Most (60.2%) were community ambulators. The overall percentage of OW/OB was 45.2%, with 49.2% of MMC and 32.0% of nonmyelomeningocele OW/OB. Following the Centers for Disease Control Obesity Severity Classification System, 19.7% of MMC were in class 1, 6.6% in class 2, and 3.5% in class 3. Univariate analysis of MMC participants demonstrated demographic (age, sex, race/ethnicity, and clinic region) and clinical variables (functional level of lesion, ambulation, and number of shunt surgeries) were associated with OW/OB. The GEE model showed that OW/OB was independently, and significantly, associated with age, sex, race/ethnicity, lesion levels, and geographic location of the clinics. CONCLUSIONS The demographic and clinical factors associated with OW/OB in children and adolescents with SB further our understanding of factors contributing to the higher prevalence of OW/OB in this population and may inform OW/OB prevention and treatment strategies.
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Affiliation(s)
- Michele Polfuss
- University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
- Children’s Wisconsin, Milwaukee, Wisconsin, USA
| | - Tiebin Liu
- Rare Disorders and Health Outcomes Team, Birth Defects Monitoring and Research Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathryn Smith
- Department of Pediatrics, Children’s Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California, USA
| | - Pamela S. Murphy
- District Medical Group Children’s Rehabilitative Services, Phoenix, Arizona, USA
| | - Elisabeth Ward
- Carter Consulting, Inc, Consultant to Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Nienke P. Dosa
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Yinding Wang
- McKing Consulting Corporation, Consultant to Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathleen J. Sawin
- University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
- Children’s Wisconsin, Milwaukee, Wisconsin, USA
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Xiong T, Kaltenbach E, Yakovenko I, Lebsack J, McGrath PJ. How to measure barriers in accessing mental healthcare? Psychometric evaluation of a screening tool in parents of children with intellectual and developmental disabilities. BMC Health Serv Res 2022; 22:1383. [PMID: 36411458 PMCID: PMC9677628 DOI: 10.1186/s12913-022-08762-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 09/08/2022] [Indexed: 11/22/2022] Open
Abstract
Caring for children with intellectual and developmental disabilities (IDD) can cause an enormous physical and emotional burden, and therefore these parents have an elevated risk to experience mental health problems. The characteristics of current healthcare systems and parents' responsibilities to care for their children seem to impede their access to mental healthcare. There is so far a lack of instruments to screen for such obstacles. The aim of this study was to develop and validate a scale for measuring barriers to accessing mental healthcare. The Parental Healthcare Barriers Scale (PHBS) was developed on the basis of an extensive literature research, input and discussion from experts and parents with lived experience. A cross-sectional survey was used to collect data from 456 parents of children with IDD. Physical health, mental health, social support, and parenting were measured for concurrent and discriminant validity of the PHBS. The PHBS scale revealed acceptable to good reliability and validity. It consists of four subscales (i.e., support accessibility, personal belief, emotional readiness, and resource availability). The PHBS found parents prioritized their children's treatments over their own mental health challenges (93.4%), did not have enough time (90.4%), and had financial concerns (85.8%). Parents in rural and remote areas had more limited resources. Findings from our study suggest increasing financial support for the parents seeking mental health services, introducing evidence-based treatments, increasing the availability of healthcare services for parents, and adjusting current services to their needs.
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Affiliation(s)
- Ting Xiong
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Canada ,grid.414870.e0000 0001 0351 6983IWK Health Centre, 5980 University Ave #5850, Halifax, NS B3K 6R8 Canada
| | - Elisa Kaltenbach
- grid.414870.e0000 0001 0351 6983IWK Health Centre, 5980 University Ave #5850, Halifax, NS B3K 6R8 Canada
| | - Igor Yakovenko
- grid.55602.340000 0004 1936 8200Dalhousie University, Halifax, Canada
| | | | - Patrick J. McGrath
- grid.414870.e0000 0001 0351 6983IWK Health Centre, 5980 University Ave #5850, Halifax, NS B3K 6R8 Canada ,grid.55602.340000 0004 1936 8200Dalhousie University, Halifax, Canada
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Harris HA, Bowling A, Santos S, Greaves‐Lord K, Jansen PW. Child ADHD and autistic traits, eating behaviours and weight: A population-based study. Pediatr Obes 2022; 17:e12951. [PMID: 35751176 PMCID: PMC9786764 DOI: 10.1111/ijpo.12951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/07/2022] [Accepted: 05/31/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Children with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) have an increased obesity risk. Although these conditions commonly co-occur, shared factors relating to obesity risk are unknown. OBJECTIVES To examine the shared and unique associations of ADHD and autistic traits with eating behaviours and BMI. METHODS Children (N = 4134) from the population-based Generation R Study were categorized into subgroups based on parent-reported ADHD and autistic traits scores at 6 years: ADHDHigh , ASDHigh , ADHD+ASDHigh and REF (reference group: ADHD+ASDLow ). Multiple linear regressions examined the associations between subgroups and eating behaviours (at 10 years) and BMIz (at 14 years), relative to REF. Mediation analyses tested the indirect effect of subgroup and BMIz through eating behaviours. RESULTS ADHD + ASDHigh children expressed both food approach (increased food responsiveness and emotional overeating) and avoidant eating behaviours (increased emotional undereating, satiety responsiveness/ slowness in eating and picky eating, and decreased enjoyment in food). ASDHigh children were more food avoidant, while ADHDHigh children had more food approach behaviours and greater BMIz. ADHDHigh and BMIz were indirectly associated with food responsiveness and emotional overeating. CONCLUSIONS ADHD and autistic trait phenotypes show distinct associations with potential obesity risk factors, and further research is needed to improve targeted early intervention.
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Affiliation(s)
- Holly A. Harris
- Department of Child & Adolescent Psychiatry/PsychologyErasmus MC, University Medical CenterRotterdamThe Netherlands,Generation R StudyErasmus MC, University Medical CenterRotterdamThe Netherlands
| | - April Bowling
- Department of Public Health and NutritionMerrimack College, School of Health SciencesNorth AndoverMassachusettsUSA,Department of PsychiatryUniversity of Massachusetts Chan Medical SchoolWorcesterMassachusettsUSA
| | - Susana Santos
- Generation R StudyErasmus MC, University Medical CenterRotterdamThe Netherlands,Department of PediatricsErasmus MC – Sophia Children's Hospital, University Medical Center RotterdamRotterdamThe Netherlands
| | - Kirstin Greaves‐Lord
- Department of PediatricsErasmus MC – Sophia Children's Hospital, University Medical Center RotterdamRotterdamThe Netherlands,Department of PsychologyUniversity of GroningenGroningenThe Netherlands,Autisme Team North‐NetherlandJonx part of Lentis Psychiatric InstituteGroningenThe Netherlands
| | - Pauline W. Jansen
- Department of Child & Adolescent Psychiatry/PsychologyErasmus MC, University Medical CenterRotterdamThe Netherlands,Generation R StudyErasmus MC, University Medical CenterRotterdamThe Netherlands,Department of Psychology, Education & Child StudiesErasmus University RotterdamRotterdamThe Netherlands
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11
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Back to Basics: Lifestyle Interventions for Adolescent Depression. Harv Rev Psychiatry 2022; 30:283-302. [PMID: 36103683 DOI: 10.1097/hrp.0000000000000343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
LEARNING OBJECTIVES After completing this activity, practitioners will be better able to:• Discuss and better understand the recently adopted screening standards for adolescents with depression and the potential advantages of using "lifestyle medicine"• Set up a process for providing effective interventions for the increased number of patients with adolescent depression• Design or update their toolbox of treatment options for adolescents with depression based on the new literature and increased demand. ABSTRACT Recently adopted quality standards recommend that pediatricians screen adolescents for depression and that they document follow-up plans for those who screen positive. As a result of these new recommendations, pediatricians and other pediatric providers, as well as psychiatrists and other mental health professionals, may face an increasing number of referrals and a growing need for effective interventions for adolescent depression. Given the widely acknowledged scarcity of traditional mental health resources, the current study reviewed the rapidly expanding array of evidence-based, but nontraditional, interventions applicable to outpatient pediatric and mental health care settings. Many of these interventions come from a lifestyle medicine framework. Lifestyle medicine interventions are congruent with the cultures of pediatrics and outpatient psychiatry, and offer additional evidence-based tools for providers managing adolescent depression. These interventions can be implemented individually or within group or community settings, and may be used in conjunction with more common interventions such as psychotherapy or psychotropic medications.
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12
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Bowling AB, Frazier JA, Staiano AE, Broder-Fingert S, Curtin C. Presenting a New Framework to Improve Engagement in Physical Activity Programs for Children and Adolescents With Social, Emotional, and Behavioral Disabilities. Front Psychiatry 2022; 13:875181. [PMID: 35599761 PMCID: PMC9122030 DOI: 10.3389/fpsyt.2022.875181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/14/2022] [Indexed: 12/03/2022] Open
Abstract
Children and adolescents with psychiatric and neurodevelopmental diagnoses such as anxiety, depression, autism, and attention-deficit/hyperactivity disorder (ADHD) face enormous health disparities, and the prevalence of these disorders is increasing. Social, emotional, and behavioral disabilities (SEBD) often co-occur with each other and are associated with unique barriers to engaging in free-living physical activity (PA), community-based exercise and sports programming, and school-based physical education. Some examples of these barriers include the significantly depleted parental reserve capacity associated with SEBD in children, child dysregulation, and previous negative experiences with PA programming and/or exclusion. Importantly, most SEBD are "invisible," so these parents and children may face more stigma, have less support, and fewer inclusive programming opportunities than are typically available for children with physical or intellectual disabilities. Children's challenging behavioral characteristics are not visibly attributable to a medical or physical condition, and thus are not often viewed empathetically, and cannot easily be managed in the context of programming. Existing research into PA engagement barriers and facilitators shows significant gaps in existing health behavior change (HBC) theories and implementation frameworks that result in a failure to address unique needs of youth with SEBD and their parents. Addressing these gaps necessitates the creation of a simple but comprehensive framework that can better guide the development and implementation of engaging, effective, and scalable PA programming for these youth and their families. Therefore, the aim of this article is to: (1) summarize existing research into SEBD-related child and parent-level barriers and facilitators of PA evidence-based program engagement; (2) review the application of the most commonly used HBC and disability health theories used in the development of evidence-based PA programs, and implementation science frameworks used in adaptation and dissemination efforts; (3) review the SEBD-related gaps that may negatively affect engagement; and (4) describe the new Pediatric Physical Activity Engagement for Invisible Social, Emotional, and Behavioral Disabilities (PAID) Framework, a comprehensive adapted PA intervention development and implementation adaptation framework that we created specifically for youth with SEBD and their parents.
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Affiliation(s)
- April B. Bowling
- School of Health Sciences, Merrimack College, North Andover, MA, United States
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Jean A. Frazier
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Amanda E. Staiano
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Sarabeth Broder-Fingert
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Carol Curtin
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Family and Community Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
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13
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Blaine RE, Bowling A, Kaur R, Davison KK. Promoting Sleep and Balanced Screen Time among School-Aged Children with Neurodevelopmental and Mental Health Disorders: A Parent Perspective. Child Obes 2021; 17:329-341. [PMID: 33877906 DOI: 10.1089/chi.2020.0335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Children with neurodevelopmental and mental health disorders (N/MHD), such as autism spectrum, mood disorders, and anxiety, are more likely to engage in excessive screen time, receive insufficient sleep, and to have obesity than neurotypical peers. However, little is known about how parents of these children approach promoting sleep and balanced screen time. Methods: We conducted semistructured interviews with 24 parents of children aged 8-15 years with a diagnosis of N/MHD to assess barriers and facilitators to promoting sleep and balanced screen time. Interviews were transcribed, double-coded using constant comparative methods, and summarized into themes using NVivo 11. Results: Many parents described children's chronic sleep challenges, often compounded by screen use and no clear solutions. When feeling overwhelmed, some parents reluctantly reported co-sleeping or allowing gaming devices in bed. Nearly all participants reported chronic, occasionally severe, conflict when managing children's screen time, with some parents experiencing opposition and physical aggression. Parents struggled to weigh the benefits of screen use (i.e., behavior management, learning, and social connection) with the costs (i.e., reduced self-care and limited physical activity). To combat barriers, parents described firm routines (i.e., "screens off" time and consistent bedtime on weekdays and weekends), moderating access (i.e., shutting down internet and no device in bedroom), verbal priming, and coping strategies (i.e., music and books). Conclusions: Parents of children with N/MHD face unique challenges in promoting sleep and balanced screen time. Given these behaviors may impact weight status and mental health, future interventions should examine ways to support parents in reducing conflict while promoting healthy habits.
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Affiliation(s)
- Rachel E Blaine
- Department of Family and Consumer Sciences, California State University, Long Beach, Long Beach, CA, USA
| | - April Bowling
- Merrimack College School of Health Sciences, North Andover, MA, USA
| | - Raghbir Kaur
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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14
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Hickingbotham MR, Wong CJ, Bowling AB. Barriers and facilitators to physical education, sport, and physical activity program participation among children and adolescents with psychiatric disorders: a systematic review. Transl Behav Med 2021; 11:1739-1750. [PMID: 34166515 DOI: 10.1093/tbm/ibab085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Children and adolescents with heterogeneous psychiatric disorders, of whom over 50% have a second psychiatric comorbidity, have low rates of physical activity and experience unique challenges to engaging in community-based exercise programming, school-based physical education programming, and targeted physical activity interventions. This contributes to elevated rates of gross and fine motor delays, lower mood and self-regulation, and increased risk of chronic diseases such as obesity and type 2 diabetes. Perform a systematic scoping review of the literature to assess known barriers to and facilitators of engaging in physical activity programming among children and adolescents with heterogeneous and/or comorbid psychiatric disorders, in order to improve engagement among this population in real world intervention settings. Systematic Boolean diagnostic and physical activity search terms were entered into PubMed, MEDLINE, PsycINFO and Web of Science for English-language studies published between 2005 and 2020, examining barriers and facilitators for common psychiatric diagnoses and general psychiatric population's engagement in physical activity, physical education, sports, or exercise interventions. Two reviewers independently reviewed titles, abstracts and full articles to determine inclusion. A total of 5,198 articles were returned; 39 relating to children and adolescents were qualified for full-text review. After review, 24 studies were included addressing barriers and facilitators across multiple diagnoses; 7 studies were quantitative, 10 were qualitative, and 7 were mixed methods. Major barriers included low motivation, low self-efficacy, depleted parental reserve capacity, social isolation, lack of staff training, and safety concerns. Major facilitators included peer support/engagement, exergames, supportive parental behaviors, and inclusive/adaptive programming. Numerous barriers and facilitators to physical activity have been identified which should inform community, school, clinical, and research intervention program design. Further research is needed to develop effective strategies that address the challenges to inclusion that children and adolescents with heterogeneous and/or comorbid psychiatric disorders face.
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Affiliation(s)
- Madison R Hickingbotham
- Department of Public Health and Nutrition, School of Health Sciences, Merrimack College, North Andover, MA, USA
| | - Catherine J Wong
- Department of Public Health and Nutrition, School of Health Sciences, Merrimack College, North Andover, MA, USA
| | - April B Bowling
- Department of Public Health and Nutrition, School of Health Sciences, Merrimack College, North Andover, MA, USA
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15
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Bowling AB, Slavet J, Hendrick C, Beyl R, Nauta P, Augustyn M, Mbamalu M, Curtin C, Bandini L, Must A, Staiano AE. The Adaptive GameSquad Xbox-Based Physical Activity and Health Coaching Intervention for Youth With Neurodevelopmental and Psychiatric Diagnoses: Pilot Feasibility Study. JMIR Form Res 2021; 5:e24566. [PMID: 33988508 PMCID: PMC8164124 DOI: 10.2196/24566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/18/2021] [Accepted: 04/13/2021] [Indexed: 01/08/2023] Open
Abstract
Background The prevalence of neurodevelopmental and psychiatric diagnoses (NPDs) in youth is increasing, and unhealthy physical activity (PA), diet, screen time, and sleep habits contribute to the chronic disease disparities and behavioral challenges this population experiences. Objective This pilot study aims to adapt a proven exergaming and telehealth PA coaching intervention for typically developing youth with overweight or obesity; expand it to address diet, screen, and sleep behaviors; and then test its feasibility and acceptability, including PA engagement, among youth with NPDs. Methods Participants (N=23; mean age 15.1 years, SD 1.5; 17 males, 9 people of color) recruited in person from clinic and special education settings were randomized to the Adaptive GameSquad (AGS) intervention or wait-list control. The 10-week adapted intervention included 3 exergaming sessions per week and 6 real-time telehealth coaching sessions. The primary outcomes included feasibility (adherence to planned sessions), engagement (uptake and acceptability as reported on process questionnaires), and PA level (combined light, moderate, and vigorous as measured by accelerometer). Descriptive statistics summarized feasibility and engagement data, whereas paired, two-tailed t tests assessed group differences in pre-post PA. Results Of the 6 coaching sessions, AGS participants (n=11; mean age 15.3 years, SD 1.2; 7 males, 4 people of color) completed an average of 5 (83%), averaging 81.2 minutes per week of exergaming. Of 9 participants who completed the exit questionnaire, 6 (67%) reported intention to continue, and 8 (89%) reported feeling that the coaching sessions were helpful. PA and sleep appeared to increase during the course of the intervention over baseline, video game use appeared to decrease, and pre-post intervention PA per day significantly decreased for the control (−58.8 min; P=.04) but not for the intervention group (−5.3 min; P=.77), despite potential seasonality effects. However, beta testers and some intervention participants indicated a need for reduced complexity of technology and more choice in exergames. Conclusions AGS shows promise in delivering a health behavior intervention remotely to youth with NPDs, but a full-scale efficacy trial with a larger sample size is needed to confirm this finding. On the basis of feedback from beta testers and intervention participants, the next steps should include reduced technology burden and increased exergame choice before efficacy testing. Trial Registration ClinicalTrials.gov NCT03665415; https://clinicaltrials.gov/ct2/show/NCT03665415.
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Affiliation(s)
- April B Bowling
- Department of Public Health and Nutrition, School of Health Sciences, Merrimack College, North Andover, MA, United States
| | - James Slavet
- Marblehead Public Schools, Marblehead, MA, United States
| | - Chelsea Hendrick
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Robbie Beyl
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Phillip Nauta
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Marilyn Augustyn
- Developmental and Behavioral Pediatrics Clinic, Boston Medical Center, Boston, MA, United States
| | - Mediatrix Mbamalu
- Developmental and Behavioral Pediatrics Clinic, Boston Medical Center, Boston, MA, United States
| | - Carol Curtin
- Department of Family Medicine and Community Health, Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, MA, United States.,Healthy Weight Research Network, Worcester, MA, United States
| | - Linda Bandini
- Department of Family Medicine and Community Health, Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, MA, United States.,Healthy Weight Research Network, Worcester, MA, United States.,Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Aviva Must
- Healthy Weight Research Network, Worcester, MA, United States.,Department of Public Health and Community Medicine, Tufts University, Boston, MA, United States
| | - Amanda E Staiano
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
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Arnell S, Jerlinder K, Lundqvist LO. Parents' perceptions and concerns about physical activity participation among adolescents with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:2243-2255. [PMID: 32713182 PMCID: PMC7543004 DOI: 10.1177/1362361320942092] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The parents of adolescents with autism spectrum disorder have a vital and proactive role in encouraging healthy physical activity habits, and they possess important knowledge about the adolescents’ needs when it comes to enhancing participation in physical activity. But promoting healthy physical activity habits in adolescents can be difficult. The purpose of this study was thus to describe parents’ perceptions of their adolescent child’s participation in physical activity and to describe the parental role in promoting such participation. Twenty-eight parents of adolescents aged 12–16 years with autism spectrum disorder were interviewed. The interviews were analyzed using an inductive content analysis approach. The parents described how challenging participation in physical activities could be for their adolescents. Despite this, they wanted to see their children participate more in physical activity but found the promotion of physical activity to be an overwhelming task that was difficult to cope with on their own. The results reveal a need for support and collaborative efforts among different actors to give these issues increased priority in order to promote the adolescents’ physical activity participation.
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