This study explored the health care transition (HCT) experiences of parents of adolescents and young adults (AYAs) with intellectual disability (ID), 18-33 years of age, including barriers and facilitators to the AYA's transition to adulthood within and between the medical, educational, community, and vocational systems. Design and methods: A qualitative descriptive design with semi-structured individual interviews with 16 parent participants was used. Purposive sampling of parents was utilized with variation on race/ethnicity and AYA age, stage in transition, and condition. This study was conducted through a major medical center in the southeast United States. Content analysis was utilized. Results: Three overarching themes represented the factors and essence of supporting AYAs with ID transition to adulthood. Inefficient and siloed systems illuminated barriers families are commonly experiencing within and between the medical, educational, community, and vocational systems. 'Left out here floundering' in adulthood, described the continued inadequacy of resources within each of these systems and parent's having to find available resources themselves. Hope despite uncertainty, included the perceived costs and benefits of their AYA's disability and the value of parent peer support in providing key knowledge of resources, strategies, and perspectives. Conclusions: Our findings illuminate the need for improved infrastructure to provide effective HCT and partnerships to help integrate HCT support within other life course systems. Results support the rationale for noncategorical HCT-focused approach. Practice implications: A parent peer coach-facilitated intervention offers promise for bridging the gap between systems and meeting family needs.

Abstract. Auditory sensory gating is commonly assessed using the Paired-Click Paradigm (PCP), an electroencephalography (EEG) task in which two identical sounds are presented sequentially and the brain’s inhibitory response to the second sound is measured. Many clinical populations demonstrate reduced P50 and/or N100 suppression. Testing sensory gating in children may help to identify individuals at risk for neurodevelopmental disorders earlier, including autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), which could lead to more optimal outcomes. Minimal research has been done with children because of the difficulty of performing lengthy EEG experiments with young children, requiring them to sit still for long periods of time. We designed a modified, potentially child-friendly version of the PCP and evaluated it in typically developing adults. The PCP was administered twice, once in a traditional silent room (silent movie condition) and once with an audible movie playing (audible movie condition) to minimize boredom and enhance behavioral compliance. We tested whether P50 and N100 suppression were influenced by the presence of the auditory background noise from the movie. N100 suppression was observed in both hemispheres in the silent movie condition and in the left hemisphere only during the audible movie condition, though suppression was attenuated in the audible movie condition. P50 suppression was not observed in either condition. N100 sensory gating was successfully elicited with an audible movie playing during the PCP, supporting the use of the modified task for future research in both children and adults.

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Utilizing the Framework Method, qualitative research determined the effects of potential barriers to healthcare access faced by 15 self-selected, consenting Indigenous women living in three different communities in the Guatemalan highlands. The women were actively involved in the nutritional recuperation program of the Community Organization, a non-profit clinic. Data collection involved recorded interviews based on a questionnaire designed to ensure culture competency. Responses were grouped into categories based on their relation to potential barriers to healthcare access and were then coded based on impacts on healthcare seeking behaviours. Intercoder reliability was measured and negotiated agreement of results was conducted to reach 100% agreement.  Analyses of coded responses compared results between communities and between available sectors of healthcare (folk, public, and non-profit). Inductive reasoning was used to determine the effect of beliefs related to illness on healthcare seeking behaviour. Analyses showed significant differences in the impact of geographical barriers to healthcare access among communities across public and non-profit sectors of healthcare, p < 0.05, and demonstrated categorization of disease states and influence of beliefs related to illness on healthcare seeking behaviour. Results demonstrated a hierarchy of barriers, with barriers such as cost, perceived quality of care, trust of medical provider, and available time only showing a negative effect once the barrier of geography was overcome. Despite the sample bias, these results give insight into factors affecting healthcare seeking behaviours that could contribute to the low utilization of healthcare seen in this population.