Children with higher levels of executive function (EF) skills consistently demonstrate higher levels of academic achievement. Despite the consistency of these associations, fundamental questions remain about whether efforts to improve an individual child's EF skills result in corresponding improvements in his or her academic performance. In the absence of experimental evidence, developmentalists have used repeated measures designs to test the nature, magnitude, and direction of the associations between EF skills and academic achievement. In contrast to previous studies, this study described how between-and within-person associations between EF and achievement address different questions. Using data from a subsample of participants (N ϭ 6,040) from the Early Childhood Longitudinal Study-Kindergarten, 2010 -2011 (ECLS-K:2011) cohort, we estimated a series of latent growth curve models with structured residuals to test the between and within-person associations between 2 dimensions of EF (working memory, cognitive flexibility) and 2 domains of academic achievement (math, reading). Whereas between-person associations between EF and achievement were large ( ϭ .55-.91), the within-person associations were small (␤s ϭ Ϫ.10 -.25). Within-person effects of earlier reading achievement on later EF skills was the most consistent finding. Results were unchanged when analyses were repeated using the subset of children who were eligible for free and reduced-price lunch, a proxy for low socioeconomic households. Results are discussed with respect to interest in improving EF skills as a means for facilitating school outcomes.

The use of live video consultations in genetics has been shown to improve patient access with high satisfaction; however, little is known about the current landscape of clinical telehealth models in the field of genetics (i.e., telegenetics). This survey aimed to address that gap across seven states and the District of Columbia. Among 51 self‐defined telegenetics programs responding to an online survey, 32 currently utilized live videoconferencing as at least one of their technologies (i.e., were “video‐capable”). Analysis of this subgroup revealed that medical institutions were the most common program setting, and prenatal and cancer services were the most common sub‐specialty. Forty‐seven percent of these programs reported billing insurance for patient care. When exploring measures of patient access among these programs, 56% had a wait time of under 2 weeks, 25% saw more than 50 patients per month, 50% estimated their geographic reach at over 200 miles, and 59% were able to provide remote telegenetics consultations to patients’ homes. Professional licensure was reported as the biggest barrier, and patient access and convenience were reported as the largest benefit and success. Among the 19 remaining programs, eight currently active programs exclusively used telephone technology; these were less likely to have a geneticist (p = 0.01), had a shorter wait time (p = 0.04), and had been established for a longer time (p = 0.02) when compared to video‐capable programs. Further, two currently active programs indicated the use of store‐and‐forward telehealth. Finally, nine programs were currently planning their programs, with a focus on video‐capable technologies and more varied patient specialties. We observed a diverse landscape of telehealth models being utilized to provide genetic services, and the data demonstrated that these programs are focused on enhancing patient access. Our query about telegenetics drew responses from programs that were not using live videoconferencing technology models, which prompts further exploration, and challenges us to develop consensus around the meaning of “telegenetics.” Similarly, our data suggest a need for continued research to assess the equivalency, accessibility, and role of telephone consultations across genetic services. While a multitude of policy factors influence which service delivery models are utilized, further research on these varied approaches, and their associated patient outcomes, is also needed to inform program development.

No abstract

Objective Teenage drivers diagnosed with attention-deficit/hyperactivity disorder (ADHD) are at significant risk for negative driving outcomes related to morbidity and mortality. However, there are few viable psychosocial treatments for teens with ADHD and none focus on the key functional area of driving. The Supporting the Effective Entry to the Roadway (STEER) program was evaluated in a clinical trial to determine whether it improved family functioning as a proximal outcome and driving behavior as a distal outcome. Method One hundred seventy-two teenagers with ADHD, combined type, were randomly assigned to STEER or a driver education driver practice program (DEDP). Results Relative to parents in the DEDP condition, parents in STEER were observed to be less negative at post-treatment and 6-month follow-up, but not at 12-month follow-up and there were no significant differences for observed positive parenting. Relative to teens in the DEDP condition, teens in STEER reported lower levels of risky driving behaviors at post-treatment and six-month follow-up, but not at 12-month follow-up. They were not observed to differ on objective observations of risky driving or citations/accidents. Conclusions The STEER program for novice drivers with ADHD was effective in reducing observations of negative parenting behavior and teen self reports of risky driving relative to DEDP; groups did not significantly differ on observations of positive parenting or driving behaviors. Public Health Significance Statement Families with a teenager with ADHD may benefit from engaging in behavioral parent training around the transition to independent driving, especially via reductions in negative parenting. Teenagers with ADHD self-reported fewer risky driving behaviors within the family-focused intervention, but these findings were not replicated on objective observations of driving.

No abstract

Aims We examined whether children of mothers with a medical condition diagnosed before or during pregnancy took longer to achieve gross motor milestones up to age 24 months. Methods We obtained information on medical conditions using self-reports, birth certificates, and hospital records in 4909 mothers participating in Upstate KIDS, a population-based birth cohort. Mothers reported on their children’s motor milestone achievement at 4, 8, 12, 18, and 24 months of age. Results After adjustment for covariates (including prepregnancy body mass index), children of mothers with gestational diabetes took longer to achieve sitting without support [Hazard Ratio (HR)=0.84, 95%CI:0.75-0.93), walking with assistance (HR=0.88, 95%CI:0.77-0.98) and walking alone (HR=0.88, 95%CI:0.77-0.99) than children of women with no gestational diabetes. Similar findings emerged for maternal diabetes. Gestational hypertension was associated with a longer time to achieve walking with assistance. These associations did not change after adjustment for gestational age or birth weight. Severe hypertensive disorders of pregnancy were related to a longer time to achieve milestones, but not after adjustment for perinatal factors. Interpretation Children exposed to maternal diabetes, gestational or pre-gestational, may take longer to achieve motor milestones than non-exposed children, independent of maternal obesity.

ObjectiveMaternal pre-pregnancy obesity is associated with several poor infant health outcomes; however studies that investigated motor development have been inconsistent. Thus, we examined maternal pre-pregnancy weight status and infants’ gross motor development.Design and MethodsParticipants consisted of 4,901 mother-infant pairs from the Upstate KIDS study, a longitudinal cohort in New York. Mothers indicated dates when infants achieved each of six gross motor milestones when infants were 4, 8, 12, 18, and 24 months old. Failure time modeling under a Weibull distribution was utilized to compare time to achievement across three levels of maternal pre-pregnancy BMI. Hazard ratios below one indicate a lower “risk” of achieving the milestone and translate to later achievement.ResultsCompared to infants born to thin and normal weight mothers (BMI <25), infants born to obese mothers (BMI>30) were slower to sit without support [HR=0.91, p=0.03] and crawl on hands and knees [HR=0.86, p<0.001], after adjusting for maternal and birth characteristics. Increased gestational age was associated with faster achievement of all milestones but additional adjustment did not impact results.ConclusionsMaternal pre-pregnancy obesity was associated with a slightly longer time for infant to sit and crawl, potentially due to a compromised intrauterine environment or reduced physically active play.

No abstract