A quarter of teens with autism go undiagnosed

About a quarter of 16-year-olds with autism spectrum disorder (ASD) have yet to receive a formal diagnosis, according to research from Rutgers.

The study, which appears in the Journal of Autism and Developmental Disorders, used a method called active multiple-source surveillance to produce what its authors believe to be the best-ever data on ASD prevalence among adolescents in our region.

“We think this is the largest ever study of ASD in this age group, and we hope it helps schools, health care providers and others with information that leads to better understanding and services,” said Walter Zahorodny, an associate professor at Rutgers New Jersey Medical School and lead author of the study.

The researchers found that, overall, 1.77 percent of 16-year-olds in northeastern New Jersey have ASD, but the condition affects males more than females, whites more than Blacks or Hispanics, and high-income adolescents more than low-income peers.

Researchers also found that one in four adolescents with ASD has not been diagnosed and that three in five ASD adolescents have one or more neuro-psychiatric conditions – most commonly attention deficient hyperactivity disorder (ADHD).=

Researchers reviewed school and health records for 4,875 of the 31,581 16-year-olds who lived in four northern New Jersey counties in 2014. That initial review identified 1,365 records that merited comprehensive evaluation and analysis, which, in turn, confirmed 560. Of those, 384 had been previously identified by monitoring when the cohort was 8 years old, and an additional 176 individuals satisfied ASD diagnostic criteria at age 16.

ASD was identified more frequently in adolescent males, 2.89 percent, compared to females, 0.62 percent.

ASD was twice as common among adolescents from high-income households compared to low-income families. ASD diagnosis also varied significantly by race and socioeconomic status. ASD was 50 percent more prevalent in white adolescents than in Black and Hispanic peers. (There weren’t enough Asian teens in the cohort to compare rates.) 

“This confirms what other studies have found about the relative occurrence of autism by sex, race and socioeconomic status in childhood, and it almost certainly reflects true incidence patterns rather than better diagnosis rates among groups that get more frequent and better medical care,” Zahorodny said. “Our study didn’t examine why prevalence rates vary, but other studies suggest a complex interaction of genes and environment.”

The study’s most important findings may be the identification of a significant number of undiagnosed autism cases, particularly among adolescents with mild forms of impairment and the high percentage of adolescents with ASD who also have other neuropsychiatric disorders.

The finding that many individuals go undiagnosed – and that many adolescents who could benefit from support never receive it – suggests that schools and healthcare providers could improve their tools for detecting ASD. The finding that most people with ASD have another neuro-psychiatric disorder suggests that this group will have more complex and possibly require more intensive interventions and planning.

The latest study was the second by this research group to examine the same group of people, but Zahorodny hopes it won’t be the last.

“We would love to continue studying this same cohort going forward because we know so much less about autism in adulthood,” Zahorodny said. “Continuing to follow this group of more than 500 people could greatly add to what is known about ASD and how it is characterized in adulthood, which will, ultimately, lead to the identification of interventions which maximize well-being.”

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JOURNAL

Journal of Autism and Developmental Disorders

DOI

10.1007/s10803-023-06058-8 

NIH study suggests measurement bias in common child behavior assessment tool

Researchers identify less biased questions that could reliably capture childhood behavior problems.

 

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ECHO INVESTIGATORS STUDY THE EFFECTS OF A BROAD RANGE OF EARLY ENVIRONMENTAL INFLUENCES ON CHILD HEALTH AND DEVELOPMENT. FOR MORE INFORMATION, VISIT ECHOCHILDREN.ORG

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CREDIT: ECHO PROGRAM

Scores from a commonly used measure of behavior problems in young children may be skewed depending on the primary language, education, and sex of the caregiver who fills out the survey, as well as the child’s age and race, according to new research from the NIH’s Environmental influences on Child Health Outcomes (ECHO) Program.

ECHO Cohort researchers analyzed data from caregivers who filled out the widely used Child Behavior Checklist (CBCL) 1.5–5 on behalf of 9,087 young children ages 18 to 71 months from 26 ECHO research sites across the United States. The caregiver-reported survey evaluates a range of behavior problems in young children.

"Understanding children's behavior can help us identify potential issues in their development and mental health down the road,” said Shuting Zheng, PhD of the University of California, San Francisco. “To do this effectively, we need reliable ways to measure their behavior equivalently for children from diverse backgrounds."

The study found that how caregivers respond to the questions on the measure was biased the most by the language used to complete the survey, followed by factors such as the caregiver's education level and sex and the child's age and race. These biases persisted after accounting for mental health disparities between these groups. Researchers noted that some information could get lost in translation and people from different cultures could understand child behavior problems differently. The gender of the person answering the questions and their level of education also had an impact and researchers pointed to parents’ expectations about how children should develop as possible influences in how they answered the survey questions. 

ECHO Cohort researchers were then able to identify some CBCL questions less affected by measurement biases introduced by sociodemographic factors but which still reliably captured childhood behavior problems. The subset of questions that showed little bias across survey-taker demographics still captures a wide range of behaviors across internalizing (e.g., emotionally reactive, withdrawn) and externalizing problems (aggressive behaviors and attention problems).

Going forward, ECHO Cohort researchers plan to apply these questions, evaluating their reliability in identifying children with clinically significant behavior problems.

“Finding questions with less measurement bias across sociodemographic groups helps researchers and clinicians measure behavior problems in different groups of kids of varying ages and family backgrounds more accurately,” Dr. Zheng said.

Dr. Zheng and Somer Bishop, PhD of the University of California, San Francisco, and Maxwell Mansolf, PhD of Northwestern University led this collaborative research that was published in the Journal of Child Psychology & Psychiatry Advances.

New program helps improve toddlers’ self-control skills and healthy eating habits

 

Peer-Reviewed Publication

SOCIETY FOR RESEARCH IN CHILD DEVELOPMENT

Two of the best predictors of life-long health and well-being are early childhood self-control skills and healthy eating habits. A new program that teaches parents how to cook with their 2-year-olds is helping toddlers excel on both fronts. Doing things like stirring ingredients together without spilling and singing a song while something is in the microwave helps toddlers learn multiple important self-control skills, like paying attention, controlling their bodies, waiting patiently, and cooperating with their parents. Toddlers also get excited about being involved in the “grown-up” activity and are more likely to try the new foods they help make. Previous research has shown that self-control in preschool predicts adult outcomes like higher incomes and fewer health problems. Similarly, healthy eating habits in preschool predict how often adults eat their fruits and vegetables. 

The Recipe 4 Success program was co-developed and rigorously tested by a team of researchers from the University of Wisconsin-Madison and The Pennsylvania State University and staff members of home visiting programs in seven cities, towns, and rural areas across Wisconsin and Pennsylvania. The results of the second randomized controlled trial of Recipe 4 Success have just been published in the journal Child Development. 

“It’s encouraging that parents and toddlers are so excited about cooking healthy foods together. Parents easily learn new strategies that turn daily routines, like making lunch, into a form of quality time with their toddlers that is both educational and fun,” said lead author, Robert Nix, professor of human development and family studies at the University of Wisconsin-Madison. “We were happy to see that parents could use what they learned in the special cooking lessons to support their toddlers’ development in other activities, like playing with blocks.” 

Recipe 4 Success was delivered as part of the Early Head Start home visiting program, one of several evidence-based home visiting programs designed for young families living in poverty and funded by the federal government. Home visiting programs partner with parents to promote the cognitive, social, emotional, and physical development of infants and toddlers, so they are prepared to succeed in school.

“Home visits are such a great way to ensure all children have the opportunity to thrive. My colleagues and I were so proud to collaborate with the dedicated home visitors who work hard every day to best serve the families in their programs. Together, we made home visits even better than they already were,” continued Nix. “Parents often participate in home visits because they want their children to be well-behaved and do well in school, which both depend on self-control skills. When Recipe 4 Success lessons were incorporated into home visits, toddlers developed better self-control skills and were willing to eat more nutritious foods, which may reduce common meal-time struggles and help children stay healthy and strong. Our next goal is to give Recipe 4 Success to as many home visiting programs as possible so even more families can benefit.” 

Families were recruited through organizations providing Early Head Start home visiting services. To be eligible, families had to be able to complete assessments in English and have a toddler. The study included 242 parents and their toddlers. Thirty-seven percent of families were white, 25% were Black, 19% were Latino, 17% were Multiracial, 2% were Asian American, and less than 1% were Native American. Ninety-one percent of caregivers were mothers, 5% were fathers, and 4% were other relatives. Forty-seven percent of parents were single or did not live with a partner. Sixty-five percent had a high school degree or less; 60% did not work outside the home; 20% had a part-time job; and 20% had a full-time job. Sixty-nine percent of families lived below the federal poverty threshold, and an additional 25% of families lived below 200% of that threshold; median family income was $1,555 per month. Fifty-one percent of toddlers were girls and 49% were boys. At the beginning of the study, toddlers were on average 2.5 years old. 

Participating families were randomly assigned to receive the Recipe 4 Success preventive intervention across 12 weeks, delivered by their regular Early Head Start home visitors during their regularly scheduled home visits, or continue to receive their usual practice Early Head Start home visits. Families who participated in Recipe 4 Success did not receive extra home visits or extra-long home visits. The program included sequenced and highly structured food preparation lessons, which provided countless opportunities for parents to practice sensitive scaffolding of children’s self-control skills and learn responsive food parenting practices. The lessons also provided many opportunities for toddlers to practice self-control and be exposed to new healthy foods. Each lesson required about 45 minutes of a typical 90-minute home visit. The goal was to help parents see how routine daily activities they had to do anyway, like cooking, could become a way to spend high-quality special time with their toddlers that also taught critically important new skills.   

After families completed the cooking lessons, they were tested to see whether they could apply the skills they had learned to other situations, such as building a block tower or completing a puzzle. The research found that parents who participated in the Recipe 4 Success program, compared to parents who continued with regular home visits, were more engaged and responsive and provided better support for their toddlers' learning of new skills, as demonstrated in video-recorded parent-child interaction tasks. They also were more effective in the way they introduced their toddlers to novel healthy foods. Moreover, their toddlers had better self-control skills, greater attention spans, and were more compliant, as demonstrated in waiting tasks, observer ratings, and parent reports. They also were more likely to continue helping to make and eat healthy foods at home, as demonstrated by food and activity diaries, collected over three days.  

The authors acknowledge some limitations to the study. Although the trial included many Latino families it had to exclude some Latino families that only spoke Spanish due to important differences in their experiences with the study, such as housing instability among more marginalized communities. Although this study demonstrated important intervention effects of Recipe 4 Success, it could not document exactly what aspects of the program accounted for parent and toddler change. For example, it may be that both the new lessons themselves and having parents be so much more involved in the focal activities that both contributed to program effects. The independent contributions of those different components is the topic of another study, currently under review.

Recipe 4 Success lessons are a cost-effective way to boost the impact of home visits. This study demonstrates how carefully designed and tested curricula can help maximize the effectiveness of human services.  

State politics, industry drive planetary health education for K-12 students in US

 

Depth, breadth of information about environmental issues varies widely, study finds

. — As much of the U.S. broils under record-setting temperatures, battles wildfires and is rocked by fierce storms, a new study suggests that the science learning standards for many public schools are not preparing young people to understand and respond to problems such as climate change that will dramatically impact their lives and those of millions of people around the globe.

Published in the Proceedings of the Royal Society B: Biological Science, the findings raise troubling questions about political bias shaping if and what the nation’s youths are learning about looming environmental crises and what these portend for the Earth’s inhabitants.

The quality and depth of the information that today’s K-12 students receive on planetary health issues vary widely across the U.S. and reflect the states’ and territories’ dominant political ideology and major industries when they adopted their science standards, say the researchers, most of who were graduate students at the University of Illinois Urbana-Champaign when they conducted the study.

They were inspired to investigate what K-12 students are learning about planetary health after taking a course on the topic led by U. of I. entomology professor and co-author Brian F. Allan, who is also the associate director for academic affairs in the School of Integrative Biology.

They found that many of the state science standards lack detailed explanations of environmental problems such as global warming and do not portray them as imminent threats or connect them with human activities such as burning fossil fuels.

“It’s deeply concerning that it’s a politicized issue,” said first author Samantha L.R. Capel, a conservation population genomicist with the Wildlife Genetics Research Laboratory in the California Department of Fish and Wildlife. “It really shouldn’t be because the health of our planet affects us all, and it’s at the detriment of our education system and our students who will be voting one day.”

Her co-authors included U. of I. alumni Lynette Strickland, a biology professor at Boston University; Alonso Favela, a postdoctoral scholar at the University of California, Irvine; C. Scott Clem, a postdoctoral research associate at the University of Georgia; and Stephany Virrueta Herrera, a biology instructor at Cristo Rey Jesuit High School, Chicago. U. of I. graduate students Sean Khan Ooi and Loralee J. Wilson also co-wrote the paper.

Team members assessed each state’s or territory’s entire set of science standards that were in effect in July 2020 on the presence and framing of five fundamental concepts and 10 major issues that they deemed critical for students’ comprehensive understanding of planetary health and the current trajectory of the global climate crisis.

Their analysis included the Next Generation Science Standards – national standards that were developed by a bipartisan group of researchers, educators and administrators from 26 states to improve and align science education for students across the U.S. The NGSS have been adopted by 17 states, the District of Columbia and Guam.

The team rated each standard on three dimensions: whether a term or phrase such as “evolution” was presented and the extent of its description; the degree to which a concept was described as affected by or affecting humans; and the level of urgency conveyed about mitigating potential threats.

A composite score was calculated for each standard, which represented the average of all its dimension scores. Mississippi’s science standards had the highest composite score at 73.8% while North Carolina had the lowest score at 20.8%. The NGSS were among the highest performers, ranked first in human impacts – but fourth in level of urgency – and third overall.

At the time first-ranked Mississippi and last-ranked North Carolina adopted their standards, they were led by Republicans and Democrats, respectively, the team found.

Yet “our data really does support this idea that Republican-led states are not doing as good a job teaching these concepts to their kids as Democrat-led states,” Capel said.

Overall, the science standards in Democrat-led states scored 18% higher on connecting environmental problems with human behavior and 33% higher on the level of urgency conveyed about mitigating these factors, the team said.

Across all the states, the team found broad disparities in the inclusion of critical terminology. Although “ecosystem” was included in nearly all the standards (91.8%), “endangered species” was mentioned in only about one-third (31.6%) of them.

“It’s incredibly, fundamentally unjust the amount of variation that we’re seeing in terms of the science students have access to,” said Strickland, the senior author of the study. “Some of the states that did the worst are among those that are going to have some of the worst crises in terms of climate – such as Louisiana, Texas and Florida.”

“Conservation,” “extinction” and “endangered species” were described as the least urgent problems – with scores of 16.7%, 12% and 10.6%, respectively – while “waste/pollution” ranked the highest at 41.2%, the team found.

“We were very surprised to see how little urgency was conveyed in terms of topics like climate change in these K-12 science standards because they essentially didn’t relay these concepts in ways that would give the impression students are being taught that these are problems that need to be solved urgently,” Allan said.

States dominated by agricultural industries had the highest scores whereas states dominated by manufacturing industries scored the lowest, although the researchers were uncertain about the causal nature of these relationships.

While the standards represent the minimum learning schools are expected to provide for their students, the team emphasized that many educators transcend these expectations.

“There are many teachers that do recognize climate change for the crisis that it is and see the trajectory of planetary health and how it’s going to affect their students,” Capel said.

“There are plenty of teachers across the country that are going beyond these educational standards and using their own language, tools and examples to enhance their students’ educational experience. However, they need to be supported by state-mandated education standards.”

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JOURNAL

Proceedings of the Royal Society B Biological Sciences

DOI

10.1098/rspb.2023.0975 

Simulator, combined with app, helps teachers correct mistakes before entering classroom

  When pilots, surgeons or others with high-stakes professions are learning their craft, they have simulators with which to practice. Now, a new study shows that a simulator, when combined with software to provide data on performance, can help teachers learn what mistakes to avoid before working with working in a real classroom.

A new study co-written by a researcher from the University of Kansas examined TeachLivE, or TLE, a simulator that allows pre-service teachers to deliver lessons in front of a virtual classroom of avatars. The avatars represent a diverse background of students with various personalities and academic skill levels. The simulator was combined with SeeMeTeach, or SMT, a recently developed web-based teacher observation app that provides real-time data on teacher performance. The results showed the simulation experience combined with personalized feedback data can support teachers’ practice of skills of their profession free of judgment while improving their performance.

The study, co-written with researchers Craig Berg and Raymond Scolavino from the University of Wisconsin-Milwaukee, was published in the journal Education Sciences. Co-author Lisa Dieker, Williamson Family Distinguished Professor in Special Education at KU, said the use of a teaching simulator can help future educators learn from their mistakes before leading a classroom of their own.

“We humans make mistakes, especially the first time we do things, and unfortunately for teachers, those mistakes are made on children,” Dieker said. “We want to ask, ‘How can we use this combined technology for developing targeted skills and helping teachers make the changes necessary?’ If you’re going to have a crash landing, let’s have it in front of an avatar.”

The mixed-reality technology features avatars that operate via AI combined with a human-in-the-loop as a user practices delivering lessons, calling on students, detecting inappropriate behavior and more. That is combined with a human user who can provide responses from students, based on the nuance of the situation and the users’ performance. SMT gathers real-time data on the teacher such as how many times they call on a certain student, how long they provide wait time for an answer and what section of the classroom draws the most attention.

Study results showed that users of the combined simulator and teaching data app used the data and feedback they gained to avoid repeating mistakes and even showed “teaching fingerprints,” or bodies of data on what they did right, and their strengths that indicated a unique teaching style.

Teacher training has traditionally relied on observation and written and verbal feedback. That method has stood the test of time, but the authors said it can be supplemented with technology that provides specific data about their performance.

“When teachers get specific information in the simulator, it not only helps them change their behaviors but to understand why they should,” Dieker said. “This work allows a lot of empowerment of the individual without being judgmental.”

The study found that teachers offering even a 15-minute lesson to avatars in TLE showed enough variation in how they interacted with student avatars to provide practice opportunities in a low-risk setting. And the data provided by the SMT app showed to be effective in helping them avoid repeating mistakes and taking lessons learned into practice. That can help all teacher educators achieve their goal of preparing great teachers who can provide students their best possible experiences from the beginnings of their careers, researchers said.

Dieker plans to continue researching ways teaching simulators and technology can help educators hone their craft before entering classrooms. That can prove especially important to students with novice teachers.

“A teacher can make or break your future,” Dieker said. “All other simulators take a logical, linear pathway. This simulator can do things you can’t through methods like role play or classroom observation. I want to help make a first-year teacher look like a third-year. Our most vulnerable students often have new teachers. I am confident emerging technology in simulation, artificial intelligence, biometrics and neurophysiological data collection can help us understand the differences between expert and novice teachers to better prepare and support all teachers.”

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JOURNAL

Education Sciences

Postsecondary Tuition, Fees and Degrees

Between the 2020-21 and 2022-23 academic years, public 4-year institutions reported approximately a 9 percent decrease in required tuition and fees for in-state, full-time, first-time degree/certificate-seeking undergraduate students (after adjusting for inflation) and a little more than a 9 percent decrease for out-of-state students. Private nonprofit 4-year institutions reported a decrease of approximately 7 percent, while private for-profit institutions reported a decrease of approximately 5 percent.  The National Center for Education Statistics released a new set of provisional data and web tables today (September 21) that includes fully edited and imputed data from the Integrated Postsecondary Education Data System (IPEDS) fall 2022 collection. This collection included three survey components: Institutional Characteristics for the 2022-23 academic year, Completions covering the period July 1, 2021, through June 30, 2022, and data on 12-Month Enrollment for the 2021-22 academic year. Other findings include:  During the 2022-23 academic year, there were 5,918 Title IV institutions in the United States and other U.S. jurisdictions. Of this total, 2,710 were classified as 4-year institutions, 1,550 were 2-year institutions, and the remaining 1,658 were less-than-2-year institutions. Of the roughly 3.6 million students receiving degrees or certificates at 4-year Title IV degree-granting institutions during the 2021-22 academic year, about 56 percent received a bachelor’s degree. This percentage varied by control of institution, with approximately 60 percent of the 2.2 million students at public institutions receiving a bachelor’s degree, roughly 51 percent of the 1.1 million students at private nonprofit institutions receiving a bachelor’s degree, and approximately 41 percent of the 248,000 students at private for-profit institutions receiving a bachelor’s degree.  During the 2021-22 academic year, the 12-month unduplicated headcount enrollment of students enrolled exclusively in distance education courses varied by institutional control. Of the approximately 6.3 million undergraduate students enrolled exclusively in distance education, around 4.6 million were enrolled at public institutions, approximately 876,000 were enrolled at private nonprofit institutions, and almost 758,000 were enrolled at private for-profit institutions. To view these tables and the corresponding data release memo, please visit https://nces.ed.gov/ipeds/use-the-data/survey-components

Young children do better at school if their dads read and play with them

 Fathers can give their children an educational advantage at primary school by reading, drawing and playing with them, according to a newly published report.

Research led by the University of Leeds has found that children do better at primary school if their fathers regularly spend time with them on interactive engagement activities like reading, playing, telling stories, drawing and singing. 

Analysing primary school test scores for five- and seven-year-olds, the researchers used a representative sample of nearly 5,000 mother-father households in England from the Millenium Cohort Study - which collected data on children born 2000-02 as they grew up.  

According to the research, dads who regularly drew, played and read with their three-year-olds helped their children do better at school by age five. Dads being involved at age five also helped improve scores in seven-year-olds' Key Stage Assessments. 

Dr Helen Norman, Research Fellow at Leeds University Business School, who led the research, said: “Mothers still tend to assume the primary carer role and therefore tend to do the most childcare, but if fathers actively engage in childcare too, it significantly increases the likelihood of children getting better grades in primary school. This is why encouraging and supporting fathers to share childcare with the mother, from an early stage in the child’s life, is critical.” 

Dads’ involvement impacted positively on their children’s school achievement regardless of the child’s gender, ethnicity, age in the school year and household income, according to the report. 

There were different effects when mums and dads took part in the same activities – the data showed that mums had more of an impact on young children’s emotional and social behaviours than educational achievement. 

The researchers recommend that dads carve out as much time as they can to engage in interactive activities with their children each week. For busy, working dads, even just ten minutes a day could potentially have educational benefits.  

They also recommend that schools and early years education providers routinely take both parents' contact details (where possible) and develop strategies to engage fathers – and that Ofsted take explicit account of father-engagement in inspections. 

This study shows that even small changes in what fathers do, and in how schools and early years settings engage with parents, can have a lasting impact on children's learning. It's absolutely crucial that that fathers aren't treated as an afterthought.

Andrew Gwynne MP, Chair of All-Parliamentary Party Group on Fatherhood

The research was funded by the Economic and Social Research Council (ESRC) and led by Dr Helen Norman, Research Fellow at Leeds University Business School, in collaboration with co-author Dr Jeremy Davies, Head of Impact and Communications at the Fatherhood Institute, and co-investigators at the University of Manchester. 

Dr Jeremy Davies, Head of Impact and Communications at the Fatherhood Institute, who co-authored the report, said: “Our analysis has shown that fathers have an important, direct impact on their children’s learning. We should be recognising this and actively finding ways to support dads to play their part, rather than engaging only with mothers, or taking a gender-neutral approach.” 

Andrew Gwynne MP, Chair of the All-Party Parliamentary Group on Fatherhood, said: "This study shows that even small changes in what fathers do, and in how schools and early years settings engage with parents, can have a lasting impact on children's learning. It's absolutely crucial that fathers aren't treated as an afterthought.” 

The final report was launched on Wednesday 20 September with an online webinar. Dr Norman and Dr Davies were joined by a panel of parental engagement experts and dads to talk about the study.  

Further Information 

The ‘Paternal Involvement & its Effects on Children’s Education (PIECE)’ Final Report, authored by Dr Helen Norman (Principal Investigator) and Dr Jeremy Davies (Co-Investigator) was published on the Leeds University Business School website on Wednesday 20 September.