1000 resultados para Project SNAP.


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Background Recent reports have suggested that the prevalence of autism and related spectrum disorders (ASDs) is substantially higher than previously recognised. We sought to quantify prevalence of ASDs in children in South Thames, UK. Methods Within a total population cohort of 56946 children aged 9-10 years, we screened all those with a current clinical diagnosis of ASD (n=255) or those judged to be at risk for being an undetected case (n=1515). A stratified subsample (n=255) received a comprehensive diagnostic assessment, including standardised clinical observation, and parent interview assessments of autistic symptoms, language, and intelligence quotient (IQ). Clinical consensus diagnoses of childhood autism and other ASDs were derived. We used a sample weighting procedure to estimate prevalence. Findings The prevalence of childhood autism was 38.9 per 10000 (95% CI 29.9-47.8) and that of other ASDs was 77.2 per 10000 (52.1-102.3), making the total prevalence of all AS Ds 116.1 per 10000 (90.4-141.8). A narrower definition of childhood autism, which combined clinical consensus with instrument criteria for past and current presentation, provided a prevalence of 24.8 per 10 000 (17.6-32.0). The rate of previous local identification was lowest for children of less educated parents. Interpretation Prevalence of autism and related ASDs is substantially greater than previously recognised. Whether the increase is due to better ascertainment, broadening diagnostic criteria, or increased incidence is unclear. Services in health, education, and social care will need to recognise the needs of children with some form of ASD, who constitute 1% of the child population.

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Background Autism spectrum disorder (ASD) was once considered to be highly associated with intellectual disability and to show a characteristic IQ profile, with strengths in performance over verbal abilities and a distinctive pattern of ‘peaks’ and ‘troughs’ at the subtest level. However, there are few data from epidemiological studies. Method Comprehensive clinical assessments were conducted with 156 children aged 10–14 years [mean (s.d.)=11.7 (0.9)], seen as part of an epidemiological study (81 childhood autism, 75 other ASD). A sample weighting procedure enabled us to estimate characteristics of the total ASD population. Results Of the 75 children with ASD, 55% had an intellectual disability (IQ<70) but only 16% had moderate to severe intellectual disability (IQ<50); 28% had average intelligence (115>IQ>85) but only 3% were of above average intelligence (IQ>115). There was some evidence for a clinically significant Performance/Verbal IQ (PIQ/VIQ) discrepancy but discrepant verbal versus performance skills were not associated with a particular pattern of symptoms, as has been reported previously. There was mixed evidence of a characteristic subtest profile: whereas some previously reported patterns were supported (e.g. poor Comprehension), others were not (e.g. no ‘peak’ in Block Design). Adaptive skills were significantly lower than IQ and were associated with severity of early social impairment and also IQ. Conclusions In this epidemiological sample, ASD was less strongly associated with intellectual disability than traditionally held and there was only limited evidence of a distinctive IQ profile. Adaptive outcome was significantly impaired even for those children of average intelligence.

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Mode of access: Internet.

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U.S. Atomic Energy Commission Report No. TID-3561(REV. 4).

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Objective: To examine the properties of the Social Communication Questionnaire (SCQ) in a population cohort of children with autism spectrum disorders (ASDs) and in the general population, Method: SCQ data were collected from three samples: the Special Needs and Autism Project (SNAP) cohort of 9- to 10-year-old children with special educational needs with and without ASD and two similar but separate age groups of children from the general population (n = 411 and n = 247). Diagnostic assessments were completed on a stratified subsample (n = 255) of the special educational needs group. A sample-weighting procedure enabled us to estimate characteristics of the SCQ in the total ASD population. Diagnostic status of cases in the general population samples were extracted from child health records. Results: The SCQ showed strong discrimination between ASD and non-ASD cases (sensitivity 0.88, specificity 0.72) and between autism and nonautism cases (sensitivity 0.90, specificity 0.86). Findings were not affected by child IQ or parental education. In the general population samples between 4% and 5% of children scored above the ASD cutoff including 1.5% who scored above the autism cutoff. Although many of these high-scoring children had an ASD diagnosis, almost all (similar to 90%) of them had a diagnosed neurodevelopmental disorder. Conclusions: This study confirms the utility of the SCQ as a,first-level screen for ASD in at-risk samples of school-age children.

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Background:  Several authors have highlighted areas of overlap in symptoms and impairment among children with autism spectrum disorder (ASD) and children with specific language impairment (SLI). By contrast, loss of language and broadly defined regression have been reported as relatively specific to autism. We compare the incidence of language loss and language progression of children with autism and SLI. Methods:  We used two complementary studies: the Special Needs and Autism Project (SNAP) and the Manchester Language Study (MLS) involving children with SLI. This yielded a combined sample of 368 children (305 males and 63 females) assessed in late childhood for autism, history of language loss, epilepsy, language abilities and nonverbal IQ. Results:  language loss occurred in just 1% of children with SLI but in 15% of children classified as having autism or autism spectrum disorder. Loss was more common among children with autism rather than milder ASD and is much less frequently reported when language development is delayed. For children who lost language skills before their first phrases, the phrased speech milestone was postponed but long-term language skills were not significantly lower than children with autism but without loss. For the few who experienced language loss after acquiring phrased speech, subsequent cognitive performance is more uncertain. Conclusions:  Language loss is highly specific to ASD. The underlying developmental abnormality may be more prevalent than raw data might suggest, its possible presence being hidden for children whose language development is delayed.

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Amongst a host of other benefits, proper physical education has the possibility to create a safe place where responsibility can be transferred from the teacher/facilitator, to the student. This is especially true with an underserved population. This critical program evaluation of the program CHARM was done for the purpose of program improvement. This research was a place for participants to share their experiences of the program. The participants were 5 underserved youth, 5 undergraduate students, 3 teachers and 1 graduate student. Observations, interviews, and document analysis were used to gather data. Data was analyzed using a first level read-through, and two second-level analyses. Summaries were written, and cross-case analyses were completed. The main finding of the research was the development of a Handbook, which is a guide to running the program. Secondary findings include issues of program structure, goal setting, meaningful relationships, roles, SNAP, and an outlier in the data.

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The 2005 National Institutes of Health (NIH) Consensus Conference proposed new criteria for diagnosing and scoring the severity of chronic graft-versus-host disease (GVHD). The 2014 NIH consensus maintains the framework of the prior consensus with further refinement based on new evidence. Revisions have been made to address areas of controversy or confusion, such as the overlap chronic GVHD subcategory and the distinction between active disease and past tissue damage. Diagnostic criteria for involvement of mouth, eyes, genitalia, and lungs have been revised. Categories of chronic GVHD should be defined in ways that indicate prognosis, guide treatment, and define eligibility for clinical trials. Revisions have been made to focus attention on the causes of organ-specific abnormalities. Attribution of organ-specific abnormalities to chronic GVHD has been addressed. This paradigm shift provides greater specificity and more accurately measures the global burden of disease attributed to GVHD, and it will facilitate biomarker association studies.

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This paper analyses some aspects of the trajectory of the Argentinian physician and sociologist Juan César García (1932-1984) in the field of Latin American Social Medicine. Three dimensions constituting his basic orientations are highlighted: the elaboration of systematic and reflective social thought; a critical attitude in questioning teaching and professional practices; a commitment to the institutionalization and dissemination of health knowledge.

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Background: A cross-cultural, randomized study was proposed to observe the effects of a school-based intervention designed to promote physical activity and healthy eating among high school students in 2 cities from different regions in Brazil: Recife and Florianopolis. The objective of this article is to describe the methodology and subjects enrolled in the project. Methods: Ten schools from each region were matched and randomized into intervention and control conditions. A questionnaire and anthropometry were used to collect data in the first and last month of the 2006 school year. The sample (n = 2155 at baseline; 55.7% females; 49.1% in the experimental group) included students 15 to 24 years, attending nighttime classes. The intervention focused on simple environmental/organizational changes, diet and physical activity education, and personnel training. Results: The central aspects of the intervention have been implemented in all 10 intervention schools. Problems during the intervention included teachers' strikes in both sites and lack of involvement of the canteen owners in schools. Conclusions: The Saude no Boa study provides evidence that public high schools in Brazil represent an important environment for health promotion. Its design and simple measurements increase the chances of it being sustained and disseminated to similar schools in Brazil.

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Background: We evaluated the effectiveness of a school-based intervention on the promotion of physical activity among high school students in Brazil: the Saude no Boa project. Methods: A school-based, randomized trial was carried out in 2 Brazilian cities: Recife (northeast) and Florianopolis (south). Ten schools in each city were matched by size and location, and randomized into intervention or control groups. The intervention included environmental/organizational changes, physical activity education, and personnel training and engagement. Students age 15 to 24 years were evaluated at baseline and 9 months later (end of school year). Results: Although similar at baseline, after the intervention, the control group reported significantly fewer d/wk accumulating 60 minutes+ moderate-to-vigorous physical activity (MVPA) in comparison with the intervention group (2.6 versus 3.3, P < .001). The prevalence of inactivity (0 days per week) rose in the control and decreased in the intervention group. The odds ratio for engaging at least once per week in physical activity associated with the intervention was 1.83 (95% CI = 1.24-2.71) in the unadjusted analysis and 1.88 (95% CI = 1.27-2.79) after controlling for gender. Conclusion: The Saude no Boa intervention was effective at reducing the prevalence of physical inactivity. The possibility of expanding the intervention to other locations should be considered.