"Girls don't have big tummies": The experiences of weight-related discussions for children with autism spectrum disorders / P. JACHYRA in Autism, 23-5 (July 2019)  

Public ISBD [article]  inAutism > 23-5 (July 2019) . - p.1096-1105 Titre : "Girls don't have big tummies": The experiences of weight-related discussions for children with autism spectrum disorders Type de document : Texte imprimé et/ou numérique Auteurs : P. JACHYRA, Auteur ; Evdokia ANAGNOSTOU, Auteur ; T. J. KNIBBE, Auteur ; C. PETTA, Auteur ; S. COSGROVE, Auteur ; L. CHEN, Auteur ; L. CAPANO, Auteur ; L. MOLTISANTI, Auteur ; A. C. MCPHERSON, Auteur Article en page(s) : p.1096-1105 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  children and youth  health communication  obesity  qualitative research Index. décimale : PER Périodiques Résumé : Children with autism spectrum disorders appear to be at a higher risk of having obesity than their typically developing peers. Although it has been recommended that healthcare providers speak to children with autism spectrum disorders about the potential health risks of unhealthy weight, no previous research has explored how healthcare providers communicate with them about this topic. The purpose of this study was to explore children's perspectives and experiences of discussing weight-related topics in healthcare consultations. Eight children were interviewed, and an interpretive phenomenological analysis informed the research approach and analysis of the data. Results indicated that weight-related discussions with healthcare providers were often met with trepidation, anxiety, anger, and frustration. Children also expressed that they experienced weight stigma in clinical visits and everyday interactions. Weight stigma was often (unwittingly) projected by healthcare providers during appointments and had debilitating effects on children. Finally, higher weights emerged as a repetitive/restricted interest, and children reported body image challenges regarding their higher weights. Frameworks and tools that are specific to the needs and abilities of children with autism spectrum disorders are needed for healthcare providers to foster positive conversations about weight-related topics in an effort to promote lifelong wellness. En ligne : http://dx.doi.org/10.1177/1362361318793020 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=401 [article] "Girls don't have big tummies": The experiences of weight-related discussions for children with autism spectrum disorders [Texte imprimé et/ou numérique] / P. JACHYRA, Auteur ; Evdokia ANAGNOSTOU, Auteur ; T. J. KNIBBE, Auteur ; C. PETTA, Auteur ; S. COSGROVE, Auteur ; L. CHEN, Auteur ; L. CAPANO, Auteur ; L. MOLTISANTI, Auteur ; A. C. MCPHERSON, Auteur . - p.1096-1105. Langues : Anglais (eng) in Autism > 23-5 (July 2019) . - p.1096-1105 Mots-clés : autism spectrum disorders  children and youth  health communication  obesity  qualitative research Index. décimale : PER Périodiques Résumé : Children with autism spectrum disorders appear to be at a higher risk of having obesity than their typically developing peers. Although it has been recommended that healthcare providers speak to children with autism spectrum disorders about the potential health risks of unhealthy weight, no previous research has explored how healthcare providers communicate with them about this topic. The purpose of this study was to explore children's perspectives and experiences of discussing weight-related topics in healthcare consultations. Eight children were interviewed, and an interpretive phenomenological analysis informed the research approach and analysis of the data. Results indicated that weight-related discussions with healthcare providers were often met with trepidation, anxiety, anger, and frustration. Children also expressed that they experienced weight stigma in clinical visits and everyday interactions. Weight stigma was often (unwittingly) projected by healthcare providers during appointments and had debilitating effects on children. Finally, higher weights emerged as a repetitive/restricted interest, and children reported body image challenges regarding their higher weights. Frameworks and tools that are specific to the needs and abilities of children with autism spectrum disorders are needed for healthcare providers to foster positive conversations about weight-related topics in an effort to promote lifelong wellness. En ligne : http://dx.doi.org/10.1177/1362361318793020 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=401

A pilot dose finding study of pioglitazone in autistic children / L. CAPANO in Molecular Autism, 9 (2018)  

Public ISBD [article]  inMolecular Autism > 9 (2018) . - 59p. Titre : A pilot dose finding study of pioglitazone in autistic children Type de document : Texte imprimé et/ou numérique Auteurs : L. CAPANO, Auteur ; A. DUPUIS, Auteur ; Jessica BRIAN, Auteur ; D. MANKAD, Auteur ; L. GENORE, Auteur ; R. HASTIE ADAMS, Auteur ; S. SMILE, Auteur ; T. LUI, Auteur ; D. ODROBINA, Auteur ; J. A. FOSTER, Auteur ; Evdokia ANAGNOSTOU, Auteur Article en page(s) : 59p. Langues : Anglais (eng) Mots-clés : Autism spectrum disorder  Clinical trial  Cytokines  Drug therapy  Efficacy  Inflammation  Maximum tolerated dose (MTD)  Physiological effects of drugs  Pioglitazone  Safety profile  Treatment Index. décimale : PER Périodiques Résumé : Background: Pioglitazone is a promising compound for treatment of core autism spectrum disorder (ASD) symptoms as it targets multiple relevant pathways, including immune system alterations. Objective: This pilot study aimed to elucidate the maximum tolerated dose, safety, preliminary evidence of efficacy, and appropriate outcome measures in autistic children ages 5-12 years old. Methods: We conducted a 16-week prospective cohort, single blind, single arm, 2-week placebo run-in, dose-finding study of pioglitazone. Twenty-five participants completed treatment. A modified dose finding method was used to determine safety and dose response among three dose levels: 0.25 mg/kg, 0.5 mg/kg, and 0.75 mg/kg once daily. Results: Maximum tolerated dose: there were no serious adverse events (SAEs) and as such the maximum tolerated dose within the range tested was 0.75 mg/Kg once daily.Safety: overall, pioglitazone was well tolerated. Two participants discontinued intervention due to perceived non-efficacy and one due to the inability to tolerate interim blood work. Three participants experienced mild neutropenia.Early evidence of efficacy: statistically significant improvement was observed in social withdrawal, repetitive behaviors, and externalizing behaviors as measured by the Aberrant Behavior Checklist (ABC), Child Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and Repetitive Behavior Scale-Revised (RBS-R). Forty-six percent of those enrolled were deemed to be global responders. Conclusions and relevance: Pioglitazone is well-tolerated and shows a potential signal in measures of social withdrawal, repetitive, and externalizing behaviors. Randomized controlled trials using the confirmed dose are warranted. Trial registration: ClinicalTrials.gov, NCT01205282. Registration date: September 20, 2010. En ligne : https://dx.doi.org/10.1186/s13229-018-0241-5 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=371 [article] A pilot dose finding study of pioglitazone in autistic children [Texte imprimé et/ou numérique] / L. CAPANO, Auteur ; A. DUPUIS, Auteur ; Jessica BRIAN, Auteur ; D. MANKAD, Auteur ; L. GENORE, Auteur ; R. HASTIE ADAMS, Auteur ; S. SMILE, Auteur ; T. LUI, Auteur ; D. ODROBINA, Auteur ; J. A. FOSTER, Auteur ; Evdokia ANAGNOSTOU, Auteur . - 59p. Langues : Anglais (eng) in Molecular Autism > 9 (2018) . - 59p. Mots-clés : Autism spectrum disorder  Clinical trial  Cytokines  Drug therapy  Efficacy  Inflammation  Maximum tolerated dose (MTD)  Physiological effects of drugs  Pioglitazone  Safety profile  Treatment Index. décimale : PER Périodiques Résumé : Background: Pioglitazone is a promising compound for treatment of core autism spectrum disorder (ASD) symptoms as it targets multiple relevant pathways, including immune system alterations. Objective: This pilot study aimed to elucidate the maximum tolerated dose, safety, preliminary evidence of efficacy, and appropriate outcome measures in autistic children ages 5-12 years old. Methods: We conducted a 16-week prospective cohort, single blind, single arm, 2-week placebo run-in, dose-finding study of pioglitazone. Twenty-five participants completed treatment. A modified dose finding method was used to determine safety and dose response among three dose levels: 0.25 mg/kg, 0.5 mg/kg, and 0.75 mg/kg once daily. Results: Maximum tolerated dose: there were no serious adverse events (SAEs) and as such the maximum tolerated dose within the range tested was 0.75 mg/Kg once daily.Safety: overall, pioglitazone was well tolerated. Two participants discontinued intervention due to perceived non-efficacy and one due to the inability to tolerate interim blood work. Three participants experienced mild neutropenia.Early evidence of efficacy: statistically significant improvement was observed in social withdrawal, repetitive behaviors, and externalizing behaviors as measured by the Aberrant Behavior Checklist (ABC), Child Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and Repetitive Behavior Scale-Revised (RBS-R). Forty-six percent of those enrolled were deemed to be global responders. Conclusions and relevance: Pioglitazone is well-tolerated and shows a potential signal in measures of social withdrawal, repetitive, and externalizing behaviors. Randomized controlled trials using the confirmed dose are warranted. Trial registration: ClinicalTrials.gov, NCT01205282. Registration date: September 20, 2010. En ligne : https://dx.doi.org/10.1186/s13229-018-0241-5 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=371

Weighty Conversations: Caregivers', Children's, and Clinicians' Perspectives and Experiences of Discussing Weight-Related Topics in Healthcare Consultations / P. JACHYRA in Autism Research, 11-11 (November 2018)  

Public ISBD [article]  inAutism Research > 11-11 (November 2018) . - p.1500-1510 Titre : Weighty Conversations: Caregivers', Children's, and Clinicians' Perspectives and Experiences of Discussing Weight-Related Topics in Healthcare Consultations Type de document : Texte imprimé et/ou numérique Auteurs : P. JACHYRA, Auteur ; Evdokia ANAGNOSTOU, Auteur ; T. J. KNIBBE, Auteur ; C. PETTA, Auteur ; S. COSGROVE, Auteur ; L. CHEN, Auteur ; L. CAPANO, Auteur ; L. MOLTISANTI, Auteur ; A. C. MCPHERSON, Auteur Article en page(s) : p.1500-1510 Langues : Anglais (eng) Mots-clés : autism spectrum disorder  health communication  health promotion  obesity  qualitative research Index. décimale : PER Périodiques Résumé : Children with autism spectrum disorder (ASD) are at a higher risk of having obesity than their typically developing peers. Although it has been recommended that health care providers (HCPs) speak to caregivers and children about the risk of higher weights, no research has examined how HCPs communicate weight-related information. Furthermore, there is a dearth of evidence regarding how to approach and deliver optimal weight-related discussions among children with ASD and their caregivers. Given these knowledge gaps, 21 in-depth interviews were conducted with children with ASD, their caregivers, and HCPs. Using a qualitative analytic approach, data from interviews were analyzed thematically. Results suggest that HCPs at times projected weight stigma during clinical encounters, which did not motivate children and caregivers to work toward work loss or wellness. HCPs also described reticence in engaging families in weight-related conversations due to limited training, and lack of clinical tools to guide these conversations. All stakeholders identified a need to work together to establish a therapeutic partnership to discuss weight-related issues without blame or shame. The combination of strength-based communication approaches, establishing a strong therapeutic partnership, and development of clinical tools facilitating weight-related discussions for HCPs outlined in this article are potential vehicles to foster successful weight-related discussions while promoting lifelong wellness. Autism Research 2018, 11: 1500-1510. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Children with autism spectrum disorder (ASD) are at a higher risk of having obesity. Yet, it is unknown how healthcare providers (HCPs) should deliver weight-related information. Findings suggest children and caregivers experienced weight stigma and were uncomfortable discussing weight-related issues. HCPs identified that they did not have sufficient training, and did not feel confident identifying/addressing weight issues. Tools are needed to facilitate weight-related discussions among children, caregivers and HCPs. En ligne : http://dx.doi.org/10.1002/aur.2017 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=370 [article] Weighty Conversations: Caregivers', Children's, and Clinicians' Perspectives and Experiences of Discussing Weight-Related Topics in Healthcare Consultations [Texte imprimé et/ou numérique] / P. JACHYRA, Auteur ; Evdokia ANAGNOSTOU, Auteur ; T. J. KNIBBE, Auteur ; C. PETTA, Auteur ; S. COSGROVE, Auteur ; L. CHEN, Auteur ; L. CAPANO, Auteur ; L. MOLTISANTI, Auteur ; A. C. MCPHERSON, Auteur . - p.1500-1510. Langues : Anglais (eng) in Autism Research > 11-11 (November 2018) . - p.1500-1510 Mots-clés : autism spectrum disorder  health communication  health promotion  obesity  qualitative research Index. décimale : PER Périodiques Résumé : Children with autism spectrum disorder (ASD) are at a higher risk of having obesity than their typically developing peers. Although it has been recommended that health care providers (HCPs) speak to caregivers and children about the risk of higher weights, no research has examined how HCPs communicate weight-related information. Furthermore, there is a dearth of evidence regarding how to approach and deliver optimal weight-related discussions among children with ASD and their caregivers. Given these knowledge gaps, 21 in-depth interviews were conducted with children with ASD, their caregivers, and HCPs. Using a qualitative analytic approach, data from interviews were analyzed thematically. Results suggest that HCPs at times projected weight stigma during clinical encounters, which did not motivate children and caregivers to work toward work loss or wellness. HCPs also described reticence in engaging families in weight-related conversations due to limited training, and lack of clinical tools to guide these conversations. All stakeholders identified a need to work together to establish a therapeutic partnership to discuss weight-related issues without blame or shame. The combination of strength-based communication approaches, establishing a strong therapeutic partnership, and development of clinical tools facilitating weight-related discussions for HCPs outlined in this article are potential vehicles to foster successful weight-related discussions while promoting lifelong wellness. Autism Research 2018, 11: 1500-1510. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Children with autism spectrum disorder (ASD) are at a higher risk of having obesity. Yet, it is unknown how healthcare providers (HCPs) should deliver weight-related information. Findings suggest children and caregivers experienced weight stigma and were uncomfortable discussing weight-related issues. HCPs identified that they did not have sufficient training, and did not feel confident identifying/addressing weight issues. Tools are needed to facilitate weight-related discussions among children, caregivers and HCPs. En ligne : http://dx.doi.org/10.1002/aur.2017 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=370

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