This study aims to evaluate the efficacy of a brief cognitive behavioral intervention program for children and adolescents experiencing persistent post-concussion symptoms. A total of 31 patients aged 10 to 18 years participated in the intervention. The median time since injury at treatment onset was 95 days though the range was large (23-720 days). Treatment was on average four sessions in duration. Sessions included concussion education, activity scheduling, sleep hygiene relaxation training, and cognitive restructuring. Outcomes were measured using symptom reports on the Sports Concussion Assessment Tool - Third Edition (SCAT-3) and parent-reported quality of life on the Pediatric Quality of Life Inventory (PedsQL). Mixed-effects models revealed that symptom reports did not decrease prior to the initiation of this treatment, though significant symptom improvement occurred following treatment. Quality of life scores significantly improved across domains, with the largest gains made in the emotional and school domains. Participant characteristics including age, sex, maternal education, and previous mental health problems were not found to be significantly related to treatment outcomes. Contrary to predictions, length of time since injury was not related to symptom changes. The primary limitation of this study is that it lacks randomization and an experimental control group. The results suggest that brief cognitive behavioral intervention may be a promising treatment for children and adolescents experiencing persistent post-concussive symptoms and warrants further investigation.

This pilot study investigated driving history and driving behaviors between adults diagnosed with autism spectrum disorders (ASD) as compared to non-ASD adult drivers. Seventy-eight licensed drivers with ASD and 94 non-ASD comparison participants completed the Driver Behavior Questionnaire. Drivers with ASD endorsed significantly lower ratings of their ability to drive, and higher numbers of traffic accidents and citations relative to non-ASD drivers. Drivers with ASD also endorsed significantly greater numbers of difficulties on the following subscales: intentional violations, F(1, 162) = 6.15, p = .01, η p (2)  = .04; mistakes, F(1, 162) = 10.15, p = .002, η p (2)  = .06; and slips/lapses, F(1, 162) = 11.33, p = .001, η p (2)  = .07. These findings suggest that individuals with ASD who are current drivers may experience more difficulties in driving behaviors and engage in more problematic driving behaviors relative to non-ASD drivers.

Sleep differences between Black and White preschool children were primarily mediated by parent behaviors rather than socioeconomic variables. Results may reflect differences in cultural practices and provide important information for treatment and parent-directed intervention regarding improving sleep in young children.

WHAT'S KNOWN ON THIS SUBJECT: Caregiver behavioral symptom ratings are frequently used to assist in diagnosing childhood behavioral disorders. Although behavioral disorders are highly comorbid with learning disabilities (LDs), little work has examined the utility of caregiver ratings of learning concerns for screening of comorbid LD. WHAT THIS STUDY ADDS:The validity of a time-and cost-efficient caregiver rating of academic concerns (Colorado Learning Difficulties Questionnaire) was examined. The screening measure accurately predicted children without LD, suggesting that the absence of parentreported difficulties may be adequate to rule out overt LD. abstract BACKGROUND AND OBJECTIVE: Behavioral disorders are highly comorbid with childhood learning disabilities (LDs), and accurate identification of LDs is vital for guiding appropriate interventions. However, it is difficult to conduct comprehensive assessment of academic skills within the context of primary care visits, lending utility to screening of academic skills via informant reports. The current study evaluated the clinical utility of a parentreported screening measure in identifying children with learning difficulties. METHODS:Participants included 440 children (66.7% male), ages 5.25 to 17.83 years (mean = 10.32 years, SD = 3.06 years), referred for neuropsychological assessment. Academic difficulties were screened by parent report using the Colorado Learning Difficulties Questionnaire (CLDQ). Reading and math skills were assessed via individually administered academic achievement measures. Sensitivity, specificity, classification accuracy, and conditional probabilities were calculated to evaluate the efficacy of the CLDQ in predicting academic impairment. RESULTS:Correlations between the CLDQ reading scale and reading achievement measures ranged from 20.35 to 20.65 and from 20.24 to 20.46 between the CLDQ math scale and math achievement measures (all P , .01). Sensitivity was good for both reading and math scales, whereas specificity was low. Taking into account the high base rate of reading and math LDs within our sample, the conditional probability of true negatives (96.2% reading, 85.1% math) was higher than for true positives (40.5% reading, 37.9% math). CONCLUSIONS:Overall, the CLDQ may more accurately predict children without LDs than children with LDs. As such, the absence of parentreported difficulties may be adequate to rule out an overt LD, whereas elevated scores likely indicate the need for more comprehensive assessment. Pediatrics 2013;132:e1257-e1264 Although community-based clinicians have been increasingly successful at acquiring parent and teacher behavior ratings 17 to assist in diagnosis of behavioral disorders such as ADHD, current diagnostic approaches to LDs are not as easily transferred to the community provider setting. 18 Specifically, a formal diagnosis of LD requires comprehensive assessment of cognitive and academic skills and/or careful assessment of the student' s response to targeted and empirically based intervention. 19 ...

Although it is widely accepted that autism spectrum disorder (ASD) involves neuroanatomical abnormalities and atypical neurodevelopmental patterns, there is little consensus regarding the precise pattern of neuroanatomical differences or how these differences relate to autism symptomology. Furthermore, there is limited research related to neuroanatomical correlates of autism symptomology in individuals with ASD and the studies that do exist primarily include small samples. This study was the first to investigate gray matter (GM) changes throughout the ASD lifespan, using voxel-based morphometry to determine whether significant differences exist in the GM volumes of a large sample of individuals with ASD compared to age- and IQ-matched typical controls. We examined GM volume across the lifespan in 531 individuals diagnosed with ASD and 571 neurotypical controls, aged 7-64. We compared groups and correlated GM with age and autism severity in the ASD group. Findings suggest bilateral decreased GM volume for individuals with ASD in regions extending from the thalamus to the cerebellum, anterior medial temporal lobes, and orbitofrontal regions. Higher autism severity was associated with decreased GM volumes in prefrontal cortex, inferior parietal and temporal regions, and temporal poles. Similar relationships were found between GM volume and age. ASD diagnosis and severity were not associated with increased GM volumes in any region.

No abstract

Although sleep problems in youth with neurodevelopmental conditions (NDC) tend to be more prevalent and severe than those of typically developing (TD) youth, their clinical presentations and needs are rarely compared in real-world settings. This study compared sleep patterns, diagnostic impressions, and treatment recommendations between a diverse outpatient sample of TD youth and those with NDC. Data were collected from electronic medical records for 327 consecutive patients (58.4% male; 52.6% White, age range = 0–20 years) presenting for an initial consultation at an outpatient sleep clinic in an urban children’s hospital. Of the sample, 45.3% had a preexisting NDC, with 7% diagnosed with autism spectrum disorder (ASD), 9.9% with Trisomy 21 or other genetic disorder, 26.8% with another developmental delay, and 16.5% with ADHD. Obstructive sleep apnea (OSA) was the most frequent diagnosis overall (64.5%). However, patients with Trisomy 21 or other genetic disorders were especially more likely than TD youth to receive an OSA diagnosis and to receive medical treatment recommendations or referrals, but less likely to receive behavioral recommendations. Although patients with ADHD presented with higher rates of OSA symptoms, patients with ADHD and/or ASD did not differ in any other ways from TD patients in their sleep patterns, diagnosis, or treatment recommendations. Findings underscore the range of sleep problems in TD youth and those with NDC. The breadth of services provided at pediatric sleep centers highlights the importance of referral to such centers when sleep problems are present, especially in children with NDC.

Findings suggest that young adults with ASD may have more difficulty with basic driving skills than peers, particularly in the early stages of driver training. Increased difficulty compared with peers increases as driving demands become more complex, suggesting that individuals with ASD may benefit from a slow and gradual approach to driver training. Future studies should evaluate predictors of driving performance, on-road driving, and ASD-specific driving interventions.