Journal on Developmental Disabilities

As part of a larger project that provides unique insight into the profile of Canadians assessed for Fetal Alcohol Spectrum Disorder (FASD) across various diagnostic clinics, the purpose of the current study was to highlight who presents for FASD assessment in Northeastern Ontario, and the related diagnostic outcomes between those who are diagnosed and those who are not. A total of 326 children and youth were included in the overall sample of individuals assessed at the only diagnostic service in the Northeastern Ontario region in Sudbury, Ontario. Specific comparisons between those diagnosed with FASD and those not diagnosed were further explored. Results indicated that functional difficulties, including both neurodevelopmental and mental health impairments, were evident in all individuals, regardless of an FASD diagnosis. However, for individuals who received a diagnosis of FASD, greater mental health concerns and neurodevelopmental impairment beyond what is necessary to receive a diagnosis were noted. While impairment at the clinical level (i.e., 2 or more standard deviations below the mean, as per Canadian FASD Diagnostic Guideline) was lower in those who did not receive a diagnosis, difficulties pertaining to behaviour and mental health were identified. Overall, the results support a multiservice need among those prenatally exposed to alcohol in the region. The findings are discussed in relation to the existing literature on the common outcomes associated with prenatal alcohol exposure, and FASD more specifically. Limitations and implications are also discussed.

Autism Spectrum Disorder (ASD; hereafter autism) is a lifelong, neurodevelopmental condition, which is diagnosed based on persistent and pervasive deficits in social communication and social interaction (APA, 2013).The estimated prevalence of autism in children has been steadily increasing in recent decades and is currently estimated at 1 in 50 in Canada and 1 in 44 in the US (CAHS, 2022; Maenner et al., 2021). There is a great variability in the autistic clinical phenotype (Toal et al., 2010). This variability may partially be explained by a wide range of genes that contribute to its susceptibility. Common co-occurring conditions include attention problems, impulsivity, sensory and behavioural dysregulation, mental disorders, feeding and sleeping difficulties, intellectual impairment, and epilepsy among other health conditions (Faras et al., 2010; Taylor et al., 2013). Autism occurs across all racial, ethnic and socioeconomic groups (CDC, 2019). The increasing prevalence of autism over time and heterogeneity of adaptive behaviour can create significant challenges for parents and families.

This research aimed to determine the attitudes and knowledge of managers and care teams within group home facilities for persons with intellectual and developmental disabilities (IDD) concerning the use of rapid point-of-care antigen testing for COVID-19 to protect residents and limit transmission. Specifically, our research asked what is the level of understanding concerning the suitability of such testing, and what barriers might exist to implementing this new technology. A small survey instrument was developed to assess knowledge and understanding specific to this sector of care facilities. This survey was distributed to approximately 250 managers and care staff of 15 group homes in Ontario for people with IDD. Of the 11 respondents, all indicated trust in this technology to identify positive COVID infection, even in asymptomatic individuals, with some respondents over-estimating the benefits of implementing this technology as a screening tool. Therefore, increasing knowledge of the limitations of rapid testing as a screening tool for visitors, residents and staff, as well as addressing barriers to adoption of point-of-care analyzers, must accompany implementation of screening at any facility.

The purpose of the research was to evaluate the effectiveness of the Safe and Sound ProtocolTM (SSP) on sensory sensitivities, digestive problems, and selective eating in individuals with autism spectrum disorder, hypothesizing a progressive decrease in symptoms at the 1-week and 4-week follow-up assessments that may be moderated by age. The effectiveness of SSP was evaluated in a prospective single-arm study, using validated caregiver reports and self-reports. Thirty-seven participants with ASD (aged 7 to 39 years) took part in the study. Auditory hypersensitivities, auditory hypo-sensitivities to voices, visual sensitivity, and digestive problems all declined at the 1-week and 4-week follow-up assessments. Tactile hypersensitivities and selective eating declined at the 4-week follow-up assessment. At the 4-week follow-up assessment, 70.3% participants showed ≥30% change in at least one domain (Cohen’s d range, week-4: .22 to .50). Age moderated some effects, as adolescents showed a reduction in visual hypersensitivities and non-social tactile sensitivity. Adult participants had a decrease in tactile sensitivities at the 4-week follow-up assessment. Results support use of SSP as a promising intervention to reduce sensory sensitivities, digestive problems, and selective eating in individuals with ASD and highlight the need for controlled clinical trials in natural settings, with considerations for control conditions and testing mechanisms of effects.

Parent-delivered, low-intensity interventions such as the Early Start Denver Model (ESDM) could provide a cost-effective solution to excessive delays between a diagnosis of autism and the provision of early intensive behavioural intervention. In this proof-of-concept study conducted in Quebec, 18 families participated in a 13-week ESDM-based training and coaching intervention. Some improvements were observed in terms of children’s developmental skills and, to a lesser degree, challenging behaviours. Parents’ teaching skills (intervention fidelity), parental sense of competence, and family quality of life also improved between baseline and the end of the program. These preliminary findings are promising and indicate an appropriate level of readiness to conduct the second phase of the evaluation of ESDM for parents (i.e., P-ESDM).