Drexel News Blog Today the United States Department of Agriculture (USDA) Economic Research Service released its annual report on food security in the United States. In 2013, more than 49 million people in the U.S., including more than 16 million children, were living in food … Continue reading “Unconscionable to Fail Our Children This Way”: Drexel’s Child Hunger Expert Available to Comment on USDA 2013 Household Food Security Data
Originally posted on DrexelNow.
In the first pilot study asking adults on the autism spectrum about their experiences with driving, researchers at Drexel University found significant differences in self-reported driving behaviors and perceptions of driving ability in comparison to non-autistic adults. As the population of adults with autism continues growing rapidly, the survey provides a first step toward identifying whether this population has unmet needs for educational supports to empower safe driving – a key element of independent functioning in many people’s lives.
“Previous research in my lab has included extensive research in driving capacity with people who have a variety of conditions such as multiple sclerosis or who had experienced traumatic brain injury,” said study co-author Maria Schultheis, PhD, an associate professor of psychology at Drexel. “When we investigate whether and under what circumstances a condition or neurological difference might affect driving ability, as a standard starting point we want to go to individuals and find out from their perspective what problems they are having on the road, in their real-world experience. That question is pivotal to shape and inform the goals of long-term research – and is especially important when we turn to look at a developmental difference like autism, where there has been too little research to establish yet whether widespread driving difficulties exist.”
Only a few previous studies have examined driving ability in individuals with autism, and those studies focused on adolescents and new drivers rather than experienced adult drivers. These studies relied on parent surveys and evaluations of discrete aspects of driving performance. The new Drexel study, published early online this month in the Journal of Autism and Developmental Disorders, used a validated survey that has been extensively used in driving research, and asked adult licensed drivers on the autism spectrum to describe their first-hand, real-world driving experiences.
“We were beginning to see discussion in the research literature that aspects of autism spectrum disorders, such as neurocognitive challenges and social recognition difficulties, could make it likely that members of this population would experience significant challenges with driving,” said the study’s lead author Brian Daly, PhD, an assistant professor of psychology in Drexel’s College of Arts and Sciences. “But that assumption hadn’t been studied in adult drivers, or based on the experiences of the drivers themselves – so these were the questions we explored.”
In this survey, adults with autism spectrum disorders reported earning their drivers’ licenses at a later age, driving less frequently and putting more restrictions on their own driving behaviors (such as avoiding driving on highways or at night), on average compared to non-autistic adults. The respondents with autism spectrum disorders also reported more traffic violations.
Because this pilot study was relatively small and based on self-reports of 78 ASD respondents and 94 non-ASD comparison participants, Schultheis and Daly noted that the differences they found were open to several possible interpretations. Autistic adults may have reported driving less often and restricting their behaviors out of self-awareness of actual difficulties or deficiencies in their driving. These difficulties and/or reduced driving exposure could also explain the higher rate of reported violations.
Alternatively, it is possible that the respondents on the autism spectrum were more honest in their answers, but no worse at driving than everyone else.
“In driving research, it’s well established that people have a positive bias when reporting their own driving skills,” said Schultheis. “Because the study relied on self-reported answers, we can’t rule out whether the respondents with autism were simply being more descriptive and honest about their difficulties than the control group.”
One intriguing finding that Daly and Schultheis noted was that the difficulties adults with autism reported were not clustered in any specific areas, such as problems related to social processing of other drivers’ or pedestrians’ expected behaviors, or difficulties with neurocognitive aspects of driving such as motion perception and reaction time.
“It suggests that the challenges these individuals are facing are more global than specific,” Daly said.
“This is such an important study,” said Paul Shattuck, PhD, an associate professor and director of the research program area in life course outcomes at the A.J. Drexel Autism Institute, who was not involved in conducting the study. “Cognitively-able adults on the autism spectrum face many barriers to full participation in society. Facilitating access to transportation options will increase the capacity for these adults to contribute to their communities.”
Daly and Schultheis are continuing to investigate driving behavior in adults with autism through further research, with funding from the A.J. Drexel Autism Institute, the first autism research center focused on a public health science approach. In the next phase of research, the team is using driving simulation in Schultheis’ lab to objectively capture aspects of actual driving performance in adults on the autism spectrum. Individuals interested in enrolling in these studies should contact schultheis@drexel.edu.
“This is a first step toward identifying, categorizing and quantifying challenges that may exist in this population,” Schultheis said. “What we find will help determine what needs there may be for interventions, from driver education programs to different kinds of training exposures.”
– See more at: http://drexel.edu/now/archive/2014/June/Autism-Driving-Study/
Originally posted on DrexelNow.
Autism Awareness Month each April brings blue lights and puzzle shapes out to shine in many communities – but does it actually lead to increased autism awareness? According to a new analysis of web search trends by researchers at Drexel University, it does appear to drive an increase in Google searches for autism – by a third over searches in March in recent years.
Brian K. Lee, PhD, an assistant professor in the Drexel University School of Public Health and research fellow of the A.J. Drexel Autism Institute, was senior author of the study with public health doctoral student Elizabeth DeVilbiss, published early online this month in the Journal of Autism and Developmental Disorders.
Using the Google trends tool (google.com/trends), they analyzed web search queries for the terms “autism” and “Asperger’s” from January 2004 through April 2014 in the United States. They also compared these trends with searches for “ADHD” to assess the possible influence of broader trends in public interest in mental health issues of special interest to younger populations.
Each April, from 2004 through 2014 (except 2005), web search interest in autism spiked – up by an average of 26 percent between March and April, followed by an average decrease by 24 percent between April and May. Even sharper April spikes have occurred from 2007 through 2014, with the average March-April increase at 33 percent in those years.
A secondary, smaller increase in “autism” searches occurred each fall. Similar spring and fall oscillations occurred in searches for “ADHD” but without the sharp spike observed in April for “autism.” The spring and fall oscillations may reflect a rebound in web searches in general, which tend to drop off in summer and winter, Lee said.
The overall search interest in “autism” was sustained but not increasing over the ten-year span the researchers analyzed. In contrast, “Asperger’s” searches had a long-term increasing trend, with the term’s popularity overall 255 percent higher in January 2014 in comparison to January 2004.
Lee and DeVelbiss pointed out a few additional spikes in the search trends that may correspond to high-impact media coverage of autism and Asperger’s disorder outside of the April awareness campaigns. The Google trends tool allows users to overlay related news headlines for search terms alongside the trend chart. Lee warned that conclusions about the correlation of news headlines to search trends should be considered with caution because many could be simply accidental correlations. However, three non-April spikes were of particular note:
http://www.google.com/trends/fetchComponent?hl=en-US&q=Asperger%27s&geo=US&date=1/2004+124m&cmpt=q&content=1&cid=TIMESERIES_GRAPH_0&export=5&w=600&h=330Autism is not the only condition for which awareness months have been linked to increased search activity. A 2011 study in BMC Cancer reported that searches for breast cancer increased each October during Breast Cancer Awareness Month between 2004 and 2009, but much lower search activity occurred for prostate and lung cancers during their respective awareness months.
Search activity is also far from the entire picture of creating awareness of autism and other conditions. Whether useful and accessible information is available as a result of that search is important.
“Whether increased awareness is meaningful is another question,” Lee said. “When a parent performs a web search, does it lead to recognition of autism in their child? Does it lead to seeking clinical testing and services?” Search trends can’t answer those questions, but can provide a glimpse of public interest in a topic.
– See more at: http://drexel.edu/now/archive/2014/June/Autism-Awareness-Search-Trends/
Drexel News Blog A new study published this week in the journal JAMA Pediatrics put a price tag on the services for individuals with autism across their lifespan: from $1.4 million for those without intellectual disability to $2.4 million for those with both autism and … Continue reading Drexel Researchers Call for an Innovation and Investment Approach to Autism Population Needs
Originally posted on DrexelNow.
Drexel broke ground today for a major expansion of its nurse-managed health center in North Philadelphia.
Philadelphia City Council President Darrell L. Clarke was on hand for the ceremonial event with Drexel President John A. Fry, benefactors Stephen and Sandra Sheller, College of Nursing and Health Professions Dean Gloria Donnelly, PhD, 11th Street Director Patricia Gerrity, PhD, Drexel trustees, faculty and students, and staff, patients and community members at 11th Street.
“When a neighborhood doesn’t have a good health care option, illness can be a barrier to every other type of progress that residents seek to make,” said Fry. “The nurses who founded the 11th Street center had innovative ideas for a holistic approach that not only treated illness, but sowed the seeds of good health. The staff handled more than 32,000 clinical visits from patients last year. That’s an incredible number, and pretty close to the maximum that the current facility can handle.”
The new two-story expansion will improve and expand current services offered to patients and the community in the center which is nationally recognized as a model of integrated care. It will also provide space for more students and faculty from Drexel’s College of Nursing and Health Professions to train in interdisciplinary care. Dedicated space in the new wing will be available for more primary care visits, as well as for services provided by graduate students in Drexel’s department of Couple and Family Therapy, plus new studio space for dance, music and art therapies. More space also opens the potential for developing new programming and services in response to the community’s evolving needs.
“As a company, Gilbane always stresses the importance of giving back so we’re very excited to be involved in a project that aligns with our core values and one that will fulfill a such critical need in the community,” said Greg Dunkle, senior vice president at Gilbane Building Company which is building the new wing at 11th Street.
The expansion is made possible by a gift of $2.5 million from the Sheller Family Foundation; the expanded building will be renamed the Stephen and Sandra Sheller 11th Street Family Health Services Center.
“This center is a testament to what can happen when a community and a university work together,” Gerrity said.
The expanded health center building will be approximately 34,000 square feet, about double the size of the current 17,000 square foot space.
The center is a comprehensive nurse-managed health care home targeting a medically underserved population. The center provides primary care integrated with behavioral health, dental care and a full range of health-promotion programs, while offering Drexel students clinical training opportunities, at the forefront of a rapidly evolving health care system. The center is located in North Philadelphia in the middle of four public housing developments, offering affordable services to urban residents and to all who seek care.
Construction is expected to be complete in the fall of 2015.
– See more at: http://drexel.edu/now/archive/2014/June/11th-St-Health-Center-Groundbreaking/
Originally posted on DrexelNow.
A new study from researchers at Drexel University adds evidence that using common antidepressant medications during pregnancy may contribute to a higher risk of autism spectrum disorders (ASD) in children, although this risk is still very small.
Results from past studies of prenatal use of selective serotonin reuptake inhibitors (SSRIs) and ASD risk have not been consistent. An ongoing challenge in this line of research is trying to tease apart potential effects of the medication on risk from the effects associated with the condition for which the medication was prescribed (most commonly depression). Based on past studies, both SSRIs and genetic factors associated with depression are likely associated with greater risk of ASD.
This new study, published online ahead of print last month in the Journal of Autism and Developmental Disorders, suggests that under-reporting of maternal depression, if not properly considered in analyses, may influence results of studies trying to address this question.
In the study, the Drexel team analyzed large population based registers of nearly 750,000 births in Denmark from 1997 through 2006. They found that about 1.5 percent of children born to women who had taken an SSRI during pregnancy were diagnosed with ASD, compared to about 0.7 percent of children born to an otherwise similar group of women not taking the medication.
“We found a two-fold increased risk for ASD associated with in utero exposure to SSRIs compared to the unexposed reference group” said lead author Nicole Gidaya, PhD. “More importantly, in our analysis we accounted for under-reporting of maternal depression in the register. This suggests that under-reporting of the confounder, maternal depression, may be a limitation in approaches previously used in the other studies.”
Gidaya, who performed this study while a doctoral student in the Drexel University School of Public Health, noted that “if the increased ASD risk we saw here is real, it is important to realize that the number of ASD cases that could be prevented by reducing SSRI exposure in pregnancy still represents only a small fraction of overall cases of ASD.”
The researchers further advised caution in interpreting the results in practice. Because of the challenges of distinguishing effects of medications from those of the condition indicating their use, more research in larger study populations will be needed to confirm the findings. In addition, the decision whether or not to use an SSRI in pregnancy is a complex one; pregnant women and their doctors need to consider women’s physical and mental health needs as well as other pregnancy-associated risks, including risks associated with untreated depression both during and after pregnancy.
However, the research team believes that the greater value of this finding is to direct further attention on understanding the mechanisms by which in utero SSRI exposure might influence the developing brain. Serotonin is a neurotransmitter whose use by the brain is altered during depression and modified by SSRI use, and has been shown to play an important role in brain development.
The authors of the current study point out that there is still a need for more population studies of possible associations between maternal SSRI use and autism, in light of the limitations of the present study and the conflicting results within the field’s previous studies of the question. They say future studies should use a large population sample where there is good quality data about exposure to medication, mental health diagnoses as well as ASD diagnoses.
“As we complete research in our attempts to understand autism’s causes we continue to realize that there are likely many genetic and non-genetic contributors,” said Craig Newschaffer, PhD, director of the A.J. Drexel Autism Institute and professor in Drexel’s School of Public Health, and the study’s senior author. “We must begin trying to map these multiple risk factors on to common pathways, so that these pathways can be a focus in our effort to prevent the impairment associated with ASD. Pathways involving the brain’s serotonin system are still one viable candidate.”
Gidaya performed this research with the support of funding from Drexel’s Office of International Programs which allowed her to travel to Denmark.
– See more at: http://drexel.edu/now/archive/2014/June/Antidepressants-Autism-Risk/
Originally posted on DrexelNow.
Older parents are more likely to have a child who develops an autism spectrum disorder (ASD) than are younger parents. A recent study from researchers from the Drexel University School of Public Health in Philadelphia and Karolinska Institute in Sweden provides more insight into how the risk associated with parental age varies between mothers’ and fathers’ ages, and found that the risk of having a child with both ASD and intellectual disability is larger for older parents.
In the study, published in the February 2014 issue of the International Journal of Epidemiology, researchers report that fathers’ and mothers advancing ages have different impacts on their child’s risk. The rise in ASD risk with parental age was greater for older mothers as compared to older fathers.
“The open question at hand really is, what biological mechanisms underlie these age effects?” said Brian K. Lee, PhD, an assistant professor in the Drexel University School of Public Health and research fellow of the A.J. Drexel Autism Institute, and senior author of the study. The observed differences in risk based on mothers’ and fathers’ ages point to a need to continue investigating underlying mechanisms of ASD that may be influenced by a mother’s age, Lee said, even though much recent discussion has focused on fathers’ and even grandfathers’ ages.
The risk of having a child with ASD had a more complicated relationship to age in women than in men – whose risk of fathering a child with ASD increased linearly with age across their lifespan. Among women giving birth before the age of 30, the risk of ASD in the child showed no association with age — it was simply very low. But for babies born to mothers aged 30 and older, the chance of developing ASD rose rapidly with the mother’s age.
Lee noted that the non-linear maternal age effect that is relatively stronger than the paternal age effect on ASD risk has been observed in previous studies, but has not received much attention.
Multiple mechanisms could be in play to account for the different patterns of risk, including environmental risk factors occurring in women after age 30. Factors such as complications in pregnancy could also underlie the effect of mothers’ ages on a child’s ASD risk but not a paternal age effect. The linear, steady increase in risk associated with fathers’ ages is consistent with the hypothesis of increased genomic alterations over the father’s lifespan that can increase risk of ASD, Lee said.
In this study, Lee and colleagues analyzed a large population registry sample of 417,303 children born in Sweden between 1984 and 2003, adjusted for numerous possible factors that could vary with parental age and also influence risk, such as family income and each parent’s psychiatric history. The study also used a particularly comprehensive case-finding approach, to identify more ASD cases than other studies might, based on all pathways to care in a socialized health system.
A goal was to study these parental age effects in more detail by looking at possible differing risks of ASD with and without intellectual disability – one of the most serious comorbid diagnoses with ASD, with a significant impact on functional status in life. This was the first population-based study with an ASD sample large enough to study ASD risk in populations of children with and without intellectual disability.
“When considering risk factors, we can’t necessarily lump all ASD cases together, even though they fall under a broad umbrella of autism,” Lee said. “We need to keep an open mind in case intellectual disability might be a marker of a different underlying mechanism.”
The finding that ASD with intellectual disability had a stronger association with older parents, compared to ASD without intellectual disability, supports continued investigation of possible different mechanisms.
Lee noted that, although age effects are important indicators of risk at the population level that could eventually help researchers identify preventable causes of disability, they aren’t very significant for a couple’s family planning because the overall risk remains low. “The absolute risk of having a child with ASD is still approximately 1 in 100 in the overall sample, and less than 2 in 100 even for mothers up to age 45.”
– See more at: http://drexel.edu/now/archive/2014/April/Autism-Risk-Older-Parents/
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Originally posted on DrexelNow.
Drexel University will begin a major expansion of its nurse-managed health center which is nationally recognized as a model of integrated care. With a new gift of $2.5 million from the Sheller Family Foundation, the center at 850 N. 11th Street will break ground for a new wing this spring, with the expanded building to be renamed the Stephen and Sandra Sheller 11th Street Family Health Services Center.
The center provides primary care integrated with behavioral health, dental care and a full range of health-promotion programs, while offering Drexel students clinical training opportunities, at the forefront of a rapidly evolving health care system. The center is located in North Philadelphia in the middle of four public housing developments, offering affordable services to urban residents and to all who seek care.
“As a therapist, I’ve worked with families who struggle with hardships that affect every aspects of their lives, including their health,” said Sandra Sheller, director, president and co-founder of the Sheller Family Foundation and a Drexel University alumna in art therapy (’04) and couple and family therapy (’05). “At 11th Street, people receive holistic, comprehensive care that recognizes their struggle and adversity cannot be separated from their health care needs. My husband and I are glad to be a contributor for a model for future health care for the entire country, one that gives students in the health care professions the best possible education and experience about health care in an underserved community.”
“We want to make certain that the best possible health services are provided to a major underserved community in our region – and also make an impact beyond that community,” said Stephen Sheller, a Drexel University trustee and prominent Philadelphia attorney, co-founder of the Sheller Family Foundation. “We’ll see that impact because 11th Street is a bellwether for the country and has set the standard for the future in terms of its entire concept of care.”
The center has been recognized as an innovator and a national model of integrated primary care by organizations including the U.S. Department of Health and Human Services, the Robert Wood Johnson Foundation (RWJF) and Institute of Medicine and the American Academy of Nursing.
Patients at the 11th Street center receive primary care services from nurse practitioners with integrated behavioral health consultations available within primary care visits as needed, and as a referred service for specialized care. Primary care services are offered in partnership with the Family Practice Counseling Network.
The center also provides a broad array of other services to promote wellness – not just treat illness – including dental care, an on-site pharmacy, a fitness center, physical therapy, yoga, nutrition education and cooking classes, creative arts therapies, social work services and more – at a single location within a community. Specialized programming emphasizes even more areas, including family-centered care and substance abuse screening and treatment in primary care. The center is a hub for many activities not traditionally considered part of health care, including distribution of fresh vegetables grown on a community farm, creating public art in the Porch Light Program and even a law clinic providing legal services and advice from Drexel law students.
The center’s comprehensive patient-centered approach to health has developed over 17 years of Drexel nursing and health professions faculty working in partnership with members of the 11th Street community and numerous supportive stakeholders.
“Many health care providers are looking to examples like ours for the best ways to offer better care to more people, at lower cost – not just to keep care affordable, but to help people live well and thrive,” said Patricia Gerrity, PhD, director of the 11th Street Family Health Services, and a professor and associate dean for community programs in Drexel’s College of Nursing and Health Professions.
“We welcomed thousands of patients for more than 32,000 clinical service visits in 2013, but due to our severe space limitations we were facing a need to limit the number of new patients we could take on,” said Gerrity. “We reached a point where we could not serve all the people who needed services. The expansion will change that.”
The new two-story expansion will provide space for more students and faculty from Drexel’s College of Nursing and Health Professions, in addition to improving and expanding current services offered to patients and the community. A groundbreaking is planned for the spring.
“Drexel has a responsibility to help build healthy communities in Philadelphia, and the 11th Street health center has been in the vanguard of that effort for more than 15 years,” said Drexel University President John A. Fry. “Steve and Sandy’s incredible vision and generous support will allow us to provide more patients with more services, while continuing to educate students at the leading edge of innovation in health care.”
Dedicated space in the new wing will be available for more primary care visits, as well as for services provided by graduate students in Drexel’s department of Couple and Family Therapy, plus new studio space for dance, music and art therapies. More space also opens the potential for developing new programming and services in response to the community’s evolving needs.
Students from Drexel’s College of Nursing and Health Professions will be better positioned to learn interdisciplinary care through practices modeled at the center, spanning areas such as nursing, nutrition sciences, physical therapy, couple and family therapy and creative arts therapies.
– See more at: http://drexel.edu/now/archive/2014/February/11th-Street-Health-Center-Expansion/
Rachel Ewing 