Variation in the mating systems of Engelmann spruce and subalpine fir was examined in two adjacent subpopulations in the Colorado Front Range. Multilocus outcrossing rates were estimated from analysis of allozyme variation in embryo and megagametophyte tissue. The overall multilocus outcrossing rate of 0.93 for spruce was significantly higher than the outcrossing rate of 0.89 for fir. Outcrossing rates varied from 0.73 to 0.97 for spruce and from 0.65 to 0.94 for fir when trees of each species were grouped according to age, size, spatial distribution, maternal heterozygosity, cone production, and year of sampling. In both spruce and fir, trees with higher levels of male-cone production and/or more clumped spatial distribution had lower outcrossing rates. Temporal variation in outcrossing rates within subpopulations, examined only in spruce, was less than variation between subpopulations. Male-cone production was significantly correlated with tree size, and regression analyses revealed that the highest outcrossing rates are expected on trees that are medium to large in size, rather than the largest trees in the forest. The results show that, while there is some temporal variation, patterns of male cone production and spatial distribution of individuals are the most important factors influencing outcrossing levels in these wind-pollinated forest trees.

IMPORTANCE Most states have passed insurance mandates requiring commercial health plans to cover services for children with autism spectrum disorder (ASD). Insurers have expressed concerns that these mandates will increase the number of children diagnosed with ASD (treated prevalence) and therefore increase costs associated with their care. To our knowledge, no published studies have addressed this question. OBJECTIVE To examine whether implementing ASD insurance mandates increases the number of commercially insured children diagnosed with ASD. DESIGN, SETTING, AND PARTICIPANTS A difference-indifferences study was performed using inpatient and outpatient health insurance claims for children 21 years or younger covered by 3 of the largest insurers in the United States

The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), Module 4 is considered a “gold-standard” instrument for diagnosing autism spectrum disorder (ASD) in adults. Although the ADOS-2 shows good sensitivity and specificity in lab-based settings, it is unknown whether these results hold in community clinics that serve a more psychiatrically impaired population. This study is the first to evaluate the diagnostic accuracy of the ADOS-2 among adults in community mental health centers (n = 75). The ADOS-2 accurately identified all adults with ASD; however, it also had a high rate of false positives among adults with psychosis (30%). Findings serve as a reminder that social communication difficulties measured by the ADOS-2 are not specific to ASD, particularly in clinically complex settings.

This qualitative study aimed to understand how community-level cultural beliefs affect families' and professionals' care for children with autism and developmental delays in immigrant communities, as a first step towards promoting early identification and access to early intervention services. The study was part of the larger New York City (NYC) Korean Community Autism Project, which was designed to identify strategies to increase awareness of autism and reduce delays in treatment seeking within the NYC Korean-American community. Our study elicited early childcare workers' and church leaders' beliefs about autism and developmental disorders and, in particular, early intervention. We also elicited responses to newly developed outreach materials targeting this community. An inductive approach was used to identify concepts and categories associated with autism. Our study confirmed that discomfort, stigma and discrimination are the prevailing community attitudes toward autism and developmental disorders in the Korean-American community. Families' and professionals' understanding of autism and their care for children are affected by these community beliefs. Approaching immigrant communities with general information about child development and education rather than directly talking about autism and developmental disorders is likely to engage more families and professionals in need for diagnostic evaluation and early intervention for autism.