Background: Despite the high prevalence of seizure, epilepsy and abnormal electroencephalograms in individuals with autism spectrum disorder (ASD), there is little information regarding the relative effectiveness of treatments for seizures in the ASD population. In order to determine the effectiveness of traditional and non-traditional treatments for improving seizures and influencing other clinical factor relevant to ASD, we developed a comprehensive on-line seizure survey.
Methods: Announcements (by email and websites) by ASD support groups asked parents of children with ASD to complete the on-line surveys. Survey responders choose one of two surveys to complete: a survey about treatments for individuals with ASD and clinical or subclinical seizures or abnormal electroencephalograms, or a control survey for individuals with ASD without clinical or subclinical seizures or abnormal electroencephalograms. Survey responders rated the perceived effect of traditional antiepileptic drug (AED), non-AED seizure treatments and non-traditional ASD treatments on seizures and other clinical factors (sleep, communication, behavior, attention and mood), and listed up to three treatment side effects.
Results: Responses were obtained concerning 733 children with seizures and 290 controls. In general, AEDs were perceived to improve seizures but worsened other clinical factors for children with clinical seizure. Valproic acid, lamotrigine, levetiracetam and ethosuximide were perceived to improve seizures the most and worsen other clinical factors the least out of all AEDs in children with clinical seizures. Traditional non-AED seizure and non-traditional treatments, as a group, were perceived to improve other clinical factors and seizures but the perceived improvement in seizures was significantly less than that reported for AEDs. Certain traditional non-AED treatments, particularly the ketogenic diet, were perceived to improve both seizures and other clinical factors. For ASD individuals with reported subclinical seizures, other clinical factors were reported to be worsened by AEDs and improved by non-AED traditional seizure and non-traditional treatments. The rate of side effects was reportedly higher for AEDs compared to traditional non-AED treatments.
Conclusion: Although this survey-based method only provides information regarding parental perceptions of effectiveness, this information may be helpful for selecting seizure treatments in individuals with ASD.
Weight gain during the childbearing years and failure to lose pregnancy weight after birth contribute to the development of obesity in postpartum Latinas.
Methods
Madres para la Salud [Mothers for Health] was a 12-month, randomized controlled trial exploring a social support intervention with moderate-intensity physical activity (PA) seeking to effect changes in body fat, fat tissue inflammation, and depression symptoms in sedentary postpartum Latinas. This report describes the efficacy of the Madres intervention.
Results
The results show that while social support increased during the active intervention delivery, it declined to pre-intervention levels by the end of the intervention. There were significant achievements in aerobic and total steps across the 12 months of the intervention, and declines in body adiposity assessed with bioelectric impedance.
Conclusions
Social support from family and friends mediated increases in aerobic PA resulting in decrease in percent body fat.
Obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. However, to date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month) and long-term (12-month) efficacy of a culturally-grounded, lifestyle intervention, as compared to usual care, for improving glucose tolerance and reducing diabetes risk in 120 obese Latino adolescents with prediabetes.
Methods
Participants will be randomized to a lifestyle intervention or usual care group. Participants in the intervention group will attend weekly nutrition and wellness sessions and physical activity sessions twice a week for six months, followed by three months of booster sessions. The overall approach of the intervention is framed within a multilevel Ecodevelopmental model that leverages community, family, peer, and individual factors during the critical transition period of adolescence. The intervention is also guided by Social Cognitive Theory and employs key behavioral modification strategies to enhance self-efficacy and foster social support for making and sustaining healthy behavior changes. We will test intervention effects on quality of life, explore the potential mediating effects of changes in body composition, total, regional, and organ fat on improving glucose tolerance and increasing insulin sensitivity, and estimate the initial incremental cost effectiveness of the intervention as compared with usual care for improving glucose tolerance.
Discussion
The proposed trial builds upon extant collaborations of a transdisciplinary team of investigators working in concert with local community agencies to address critical gaps in how diabetes prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent type 2 diabetes in this and other populations of high-risk youth.
Methods: The Eye to Eye mentorship program assessed involved mentors and mentees who completed 12 in-person art sessions out of the normal 20 in-person sessions. The first main assessment was the BLD (Breger Learning Difference) Feedback Survey addressing one’s experience in the Eye to Eye program and which were completed at the end of the mentorship program and filled out by mentors, mentees, and mentees parents (one parent for each mentee). A total of 12 mentors, 6 mentees, and 6 mentee parents were included in the feedback survey final analysis. The second main assessments were the pre and post Behavior Assessment System for Child, Third Edition (BASC-3) provided to mentors, mentees, and mentees parents (one parent for each mentee). A total of 10 mentors, 5 mentees, and 5 mentee parents were included in pre and post BASC-3 final analysis. Fall 2019 (pre) and Spring 2020 (post) optional interviews involved 5 mentors and 3 mentees who showed interest and were comfortable participating with additional release forms.
Results: The program was generally positively rated in the feedback survey by mentors, mentees, and mentee parents. The highest responses for mentors, mentees, and mentee parents all incorporated average ratings of 4.0 or higher (out of 5.0) for perceived understanding of socio-emotional skills after Eye to Eye, experience in Eye to Eye, how having a mentor or mentee made them feel, and perceived change in self-awareness. All three groups reported fairly high ratings of improved self-awareness of 4.0/5.0 or above. No negative ratings were provided by any participants and the lowest response was no change. The BASC-3 evaluation found statistically significant improvement in mentors’ anxiety and atypicality and mentees’ sense of inadequacy.
Discussion: The Eye to Eye program was popular and well-rated despite only involving 12 in- person one-hour art sessions. The mentors, mentees, and mentee parents felt positive about the Eye to Eye program when answering the feedback survey. Some suggestions are made on how to improve this program to better enhance someone with learning differences future ability to succeed. Future research is needed to assess the true impact due to the COVID-19 epidemic and other limitations.
To truly understand the difficulty some adult second language learners have with learning a second language it can be helpful to compare second language acquisition to how one naturally, and seemingly effortlessly in many cases, acquires their native language. How can a comparative analysis of how native speakers and adult second language learners each learn their first and second language respectively be successfully converted to a specific means of assisting adult second language learners achieve the highest level of possible fluency? In order to more accurately propose a viable solution to the overarching question, the following three questions have been proposed as a means to springboard into better understanding the nature of the main topic.
The points to consider while analyzing the main question throughout this analysis are as follows: How would it be best for an adult second language learner to achieve the same level off proficiency as a native speaker of a given language whom has been exposed to all of its intricacies since birth? At what point exactly is someone considered to have the same level of proficiency which a native speaker of a given language would have and how does that differ from being a heritage speaker? With the final supporting question being: What type of learning would be best suited in helping a heritage speaker (someone who learns a language in the home by virtue of their heritage) or adult second language learner to become highly proficient in a second language?
In order to propose a wide variety of integration between these questions with the conjoined purpose of answering the inquiry of this thesis, many different sources supporting each of the above questions will contain certain overlap, providing a clear basis for constructing a tri-fold argument in answering the thesis question as acutely as possible. In regards to the first question, the question of “proficiency” will be a subsection committed to understanding the nature of how language proficiency works and at what point (if ever) one can ever be considered “highly proficient” in a second language.
All three exploratory questions are compatible with a theory known as Critical Period Theory, a theory in linguistics proposed by Montreal neurologist Wilder Penfield, which states, “There is a critical age, before puberty, that one must learn language. If one has not learned to speak before puberty it is much more difficult, and sometimes impossible, to learn language and speak in a meaningful way.” The overlap which this method binds to Universal Grammar is a rather close-knit relationship. Research composed by certain linguists suggest that “children are born with a certain universal grammar wired into their brains.” This will be compared and cross-examined to a higher degree in a later section of the paper.
The importance of Universal Grammar in relation to Critical Period Theory cannot be overstated. Universal Grammar in relation to the second language Critical Period Theory will help explain at which point, someone is considered to be a “native speaker” of a given language. The third question posed of how would it be best for heritage and second language learners to increase their proficiency in a second language really touches on both of these theories in regards to at which age someone is exposed to a specific language in addition to how Universal Grammar affects the development of second language acquisition. In the realm of perpetually working towards mitigating an answer to this analysis’s thesis, the connecting thread or “roter Faden”, as it is said in German, will be the integrative domain the above questions will have on arriving to a clearer understanding of the nature of how a comparative analysis of second language learners and mother-tongue speakers can expedite the language learning process of second language learners, using techniques of native speakers which they inherently pick-up.