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One-half of school-aged CSHCN with ASD were aged 5 years and over when they were first identified as having ASD. Just over one-half of school-aged CSHCN with ASD use three or more health care services to meet their developmental needs. More than one-half of school-aged CSHCN with ASD use one or more psychotropic medications to meet their developmental needs. The median age when school-aged children with special health care needs (CSHCN) and autism spectrum disorder (ASD) were first identified as having ASD was 5 years.
School-aged CSHCN identified as having ASD at a younger age (under age 5 years) were identified most often by generalists and psychologists, while those identified later (aged 5 years and over) were identified primarily by psychologists and psychiatrists. Nine out of 10 school-aged CSHCN with ASD use one or more services to meet their developmental needs. Autism Spectrum Disorder (ASD) is a set of complex neurodevelopment disorders characterized by mild to severe problems in social interaction and communication along with restricted repetitive behavior patterns (1). Fewer than one-fifth of school-aged CSHCN with ASD were identified as having ASD within the first 2 years of life. Two-fifths of school-aged CSHCN with ASD were aged 6 years and over when first identified as having ASD.
School-aged CSHCN identified as having ASD before age 5 years were most often identified by generalists (such as pediatricians, family physicians, and nurse practitioners) and psychologists. Relative to those school-aged CSHCN identified at age 5 years and over, those identified as having ASD before age 5 years were more likely to be identified by generalists, specialist pediatricians, neurologists, and multidisciplinary teams. School-aged CSHCN identified as having ASD at age 5 years and over were identified primarily by psychologists and psychiatrists. Across both age groups, approximately 9 out of 10 CSHCN with ASD use one or more of the eight services included in the Pathways survey. Younger CSHCN with ASD are more likely than older CSHCN with ASD to use any of these eight services and to use three or more of these services.
The most commonly used services are social skills training and speech or language therapy for both age groups. About 40% of school-aged CSHCN with ASD use behavioral intervention or modification services to meet developmental needs.
Younger CSHCN with ASD are more likely than older CSHCN with ASD to use occupational therapy and speech or language therapy to meet their developmental needs. More than one-half of school-aged CSHCN with ASD use at least one psychotropic medication to meet their developmental needs. Almost one-third of school-aged CSHCN with ASD use stimulant medications, one-quarter use anti-anxiety or mood-stabilizing medications, and one-fifth use antidepressants.
This report describes school-aged CSHCN with ASD, looking at when they were reported to be first identified as having ASD, who made the identification, and the services and medications they currently receive to meet their developmental needs. Most families use a combination of services to address the developmental needs of their CSHCN with ASD. Children with special health care needs (CSHCN): The National Survey of CSHCN (NS-CSHCN) used the CSHCN Screener (11) to identify CSHCN. The Survey of Pathways to Diagnosis and Services is a nationally representative survey about children with special health care needs (CSHCN) aged 6a€“17 years ever diagnosed with autism spectrum disorder (ASD), intellectual disability, or developmental delay. Parents or guardians who previously participated in the 2009a€“2010 NS-CSHCN (sponsored by the Maternal and Child Health Bureau) and who reported that their child had ever been diagnosed with at least one of the three selected developmental conditions were recontacted via landline or cell telephone to participate in the Pathways survey.
Beverly Pringle and Lisa Colpe are with the National Institutes of Health's National Institute of Mental Health, Division of Services and Intervention Research. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
Kids don't easily outgrow the pain of bullying, according to a new study that finds that people bullied as kids are less mentally healthy as adults.
The study is one of the first to establish long-term effects of childhood bullying, which is still often considered a typical part of growing up. Previous studies have found that both bullies and their victims are at higher risk for mental health problems and other struggles in childhood. For bully victims, being targeted can result in increased suicide risk, depression, poor school performance and low self-esteem.
Copeland and his colleagues used data from a study begun 20 years ago, which queried 1,420 children and their parents about general mental health beginning ate age 9, 11 or 13. Before age 16, participants were asked whether they had been bullied or bullied others, how frequently, and where any bullying occurred, among other questions. Five percent of the kids, or 112, were bullies only, and 21.6 percent, or 335 kids, were pure victims. The researchers then looked at the mental health outcomes of each group in young adulthood, controlling for childhood factors such as pre-existing mental health conditions, struggles with home life and childhood anxiety levels.


Pure victims, on the other hand, were at higher risk for depression, anxiety, panic attacks and agoraphobia than kids uninvolved in bullying, the researchers found.
For example, pure victims were four times as likely to develop an anxiety disorder in adulthood compared with kids who were uninvolved in bullying. Because they were able to take childhood mental health into account, the researchers are confident that the adult mental health struggles are an effect of the bullying, not pre-existing conditions that made them vulnerable to bullies in the first place. While it's not yet clear why bullying might have such a long-term effect, it's possible that torment at school is not so dissimilar to maltreatment or abuse in the home, Copeland said.
The next step, Copeland said, is to investigate what makes some bullied kids more resilient and able to bounce back in adulthood than others. In January, the Centers for Disease Control and Prevention reported that the numbers of twins in the U.S. Gluten is a protein composite which is found in processed foods like grain species akin to wheat and barley. Social skills training and speech or language therapy are the most common, each used by almost three-fifths of these children. ASD symptoms begin before age 3 years and last into adulthood, although symptoms may improve over time.
Percent distribution of child's age when parent or guardian was first told that child had autism spectrum disorder among children aged 6a€“17 years with special health care needs and autism spectrum disorder: United States, 2011. Early identification is an important first step toward making sure that children with ASD and their families are able to access and benefit from early intervention, which has been associated with positive developmental outcomes (5a€“7). Social skills training and speech or language therapy are the most commonly used, followed by occupational therapy.
This screener uses the health consequences that children experience as criteria for identifying special health care needs, rather than just specific diagnoses or health conditions. The survey and this report are part of the Pathways to Diagnosis and Services Study, which was sponsored and co-led by the National Institute of Mental Health, using funds available from the American Recovery and Reinvestment Act of 2009.
To be eligible, the CSHCN had to be aged 6a€“17 years at the time of the Pathways interview and still living in the same household as the recontacted parent or guardian.
Stephen Blumberg and Rosa Avila are with the Centers for Disease Control and Prevention's National Center for Health Statistics, Division of Health Interview Statistics.
Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder.
Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA young autism project model. Identifying children with special health care needs: Development and evaluation of a short screening instrument. Diagnostic history and treatment of school-aged children with autism spectrum disorder and special health care needs.
One study, presented in 2010 at the Annual Convention of the American Psychological Association, found that bullies were at higher risk of substance abuse, depression, anxiety and hostility than non-bullies. The kids were assessed annually until age 16, and then they came back for follow-ups at ages 19, 21 and 25. Pure bullies did not show problems with emotional functioning as adults, Copeland said, which is unsurprising given that they had all the power in their childhood relationships. Kids spend a lot of time at school and surrounded by peers, he said, so it's not surprising that troubles there could have long-lasting consequences.
It is a type of protein substance that resides when starch is extracted from cereal grains and gives cohesiveness to dough. There is no one best treatment for ASD, but the American Academy of Pediatrics recommends early behavioral intervention once a child is diagnosed (2). Among school-aged CSHCN with ASD, a majority were aged 5 years and over when they were first identified as having ASD, while only one in five was identified as having ASD within the first 3 years of life.
Twelve percent of CSHCN with ASD do not use any of the eight services included in the survey, whereas fewer than one-half use behavioral intervention or modification services, the most well-established and efficacious intervention for ASD (2,8,9).
Specific medication names were not solicited, but if the parent knew the name of the drug but not the type, the interviewer could refer to a list of drug names matched to type of medication. Of the parents or guardians with eligible CSHCN, 71% were successfully recontacted and 87% agreed to participate.
Michael Kogan is with the Health Resources and Services Administration's Maternal and Child Health Bureau, Office of Epidemiology and Research. Nearly all children (94%) with ASD have special health care needs, defined as requiring health or related services beyond those required by children generally (3,4).
A wide range of health care providersa€”including general and specialist physicians, mental health specialists, and othersa€”were the first professionals to identify CSHCN as having ASD.
Younger CSHCN with ASD are more likely than older CSHCN with ASD to use any services and multiple services, in part because they are more likely to use occupational therapy and speech or language therapy to meet their developmental needs.


A total of 4,032 interviews were completed from Februarya€“May 2011, an average of 9 months after the initial interview. People with this disorder have little empathy and few scruples about manipulating others for their own gain.
The allergy reactions can be broadly categorized as; Eczema which is characterized by Itchy bruises, swellings or extremely dry patches of skin that are red or dark brown in color and when peeled off release fluid.
This report provides information on diagnosis and treatment of school-aged (6a€“17 years) children with special health care needs (CSHCN) and ASD. A majority of CSHCN recognized as having ASD at age 5 years and over were identified by psychologists and psychiatrists, whereas no one type of health care provider identified more than 20% of CSHCN recognized as having ASD before age 5 years. More than one-half of school-aged CSHCN with ASD use at least one psychotropic medication, with stimulants being the most common. This report presents selected measures of diagnostic history and health care experience for the 1,420 CSHCN who were reported to have an ASD at the time of the Pathways interview. Chalk it up to more and more couples using assisted reproductive technology, as well as an increase in women waiting to have kids until their 30s when the odds of having twins increases, AP said.
It is called slapped-cheek syndrome because of the characteristic initial red marks on the face in children.Although it can resemble other childhood rashes, such as rubella or scarlet fever, slapped cheek syndrome usually begins with the distinctive, sudden appearance of bright red cheeks that look as if the child has been slapped.
Medication use spans a variety of medication classes, perhaps reflecting treatment of co-occurring symptoms or absence of clear practice guidelines for psychotropic medication use in children with ASD (10).
Most bullies did not go on to have the disorder, Copeland said, but they were more likely to develop it than other groups. The NS-CSHCN response and realization rates were about 25%; unpublished analyses suggest no significant nonresponse bias in estimates of the prevalence or characteristics of CSHCN with ASD.
It is spread by respiratory droplets that enter the air when an infected person coughs or sneezes, or through blood. For more information about the Pathways survey, including questionnaire content, please visit Survey of Pathways to Diagnosis and Services website. It poses little risk to healthy children and adults, but pregnant women without immunity to slapped cheek syndrome have an increased risk of miscarriage because it can cause anaemia in the unborn baby.What causes slapped cheek syndrome?Slapped cheek syndrome is caused by parvovirus B19 and is spread by respiratory secretions from an infected person. The incubation period (the period between infection and signs or symptoms of illness) is usually four to 14 days, but can be as long as 21 days.
The rash fades from the centre of red areas towards the edges, giving it a lacy appearance. The rash can recur after exercise, warm baths, rubbing the skin or emotional upset.Less commonly, headache, sore throat and joint painNot all children with slapped cheek syndrome develop the rash.
Conversely, parents of some children may become concerned if the rash lasts several weeks or fluctuates with environmental factors, such as exercise and warm baths.
A blood test can confirm whether you have fifth disease, but this is not usually necessary. If a pregnant woman has been exposed to slapped cheek syndrome, she needs to go to her doctor straight away to get a blood test to determine whether she has had fifth disease in the past and is, therefore, immune, or if she is currently infected. If she contracts slapped cheek syndrome in the first 20 weeks of pregnancy, she will be given regular ultrasound scans to monitor foetal growth and development, and possible complications in the foetus, such as abnormal pooling of fluid round the heart, lungs or abdomen.
What are the treatments for slapped cheek syndrome?Generally, no treatment for slapped cheek syndrome is necessary for otherwise healthy children and adults who get it.
For those with joint pain, especially in adults, anti-inflammatory pain relievers such as ibuprofen can be helpful.
Anyone who has sickle cell anaemia, chronic anaemia, or an impaired immune system can receive immunoglobulin by injection to help fight off the virus. Some of these patients may also need transfusions of red blood cells.How can I prevent slapped cheek syndrome?There is no vaccine against slapped cheek syndrome. It's easier for the virus to spread indoors, where people are likely to be in closer contact Make sure children are not crowded together, especially during nap time Teach children to cough or sneeze into a tissue (which should be thrown away immediately) or their elbow (which is less likely than their hands to spread the virus) and away from other people Children with slapped cheek syndrome generally do not need to be excluded from childcare, as they are unlikely to be contagious after the rash appears and a diagnosis is madePregnant women and slapped cheek syndromeIf a woman is certain she has had slapped cheek syndrome, there is no need to be concerned about exposure to the disease during pregnancy. If she is uncertain, a blood test can determine whether the woman has had slapped cheek syndrome in the past and is therefore immune. For instance, if there is an outbreak of slapped cheek syndrome in the workplace, a pregnant woman should discuss with her doctor whether she should stay home from work until it subsides. At home, she should wash her hands thoroughly after touching tissues used by infected children and dispose of tissues promptly.



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