RCT Of An Intervention To Improve The Health Of Adolescents With Intellectual Disability.
Funder
National Health and Medical Research Council
Funding Amount
$803,146.00
Summary
A high number of people with intellectual disability die at a younger age than the general population - 5 to 20 years younger. The standard of their health is low compared with others. They experience high levels of unrecognised disease and do not receive health promotion or health screening. As they comprise 2.7% of our population (502,000 Australians) - this situation is unjust and should be rectified. The barriers to good health for them include communication difficulties, impaired recall of ....A high number of people with intellectual disability die at a younger age than the general population - 5 to 20 years younger. The standard of their health is low compared with others. They experience high levels of unrecognised disease and do not receive health promotion or health screening. As they comprise 2.7% of our population (502,000 Australians) - this situation is unjust and should be rectified. The barriers to good health for them include communication difficulties, impaired recall of significant health information, negative social attitudes and inadequate training about disability for health service providers. This project is an attempt to minimise some of these barriers by examining the use of a Health Intervention Package. We want to give young people with intellectual disabilty the chance of similar health standards to the rest of the population. This package includes a comprehensive health review, a diary for collecting and storing health information, and advocacy training. We specifically want to examine if adolescents with intellectual disabilty using this package will receive better healthcare and improved health outcomes. We envisage that if successful, the intervention will establish good health practices for the rest of the young person's life. This group of young people is particularly at risk as they move from care provided by specialist paediatricians to accessing General Practitioners' services. To achieve this, the study will seek to recruit 1000 young people (and their parents and teachers) in Special Schools in Queensland. We have already shown that the comprehensive health review does improve health outcomes adults with intellectual disabilty, and the health information and advocacy training has received very positive evaluation. We now need to investigate the effect of both these processes in adolscence and establish if evidence exists to support wider implementation throughout the sector.Read moreRead less
Motor Functioning In Autism And Asperger's Disorder: Furthering Current Neurobehavioural And Clinical Definitions
Funder
National Health and Medical Research Council
Funding Amount
$354,932.00
Summary
While it is well known that autism and Asperger's disorder are associated with social, communicative, and behavioural symptoms, it is less well known that affected individuals also have considerable movement and coordination difficulties. For example, these children often have problems with hand writing, walking, hopping, skipping, catching, and running. These skills are very important for success at school; for example, if children are unable to participate in school sports they often feel isol ....While it is well known that autism and Asperger's disorder are associated with social, communicative, and behavioural symptoms, it is less well known that affected individuals also have considerable movement and coordination difficulties. For example, these children often have problems with hand writing, walking, hopping, skipping, catching, and running. These skills are very important for success at school; for example, if children are unable to participate in school sports they often feel isolated and rejected from the peer group. Also, hand writing problems have a significant impact on children's academic performance. Our previous research has suggested that there may be particular patterns of motor problems that characterise individuals with autism and Asperger's disorder. Our proposed research aims to use the kinds of 3D motion analysis technology used in the movie industry to capture exactly how people affected by these conditions move and respond to the environment. This study will enable us to highlight particular parts of the brain-motor circuitry that are affected by these disorders and will also enable us to more clearly distinguish how autism is different from Asperger's disorder. Ultimately, it is hoped that our motor investigations will lead to improved assessment and interventions for these disorders.Read moreRead less
Prader-Willi Syndrome (PWS) is characterised by symptoms such as obsessions, overeating, rage attacks, skin picking, irregular sleep breathing and temperature control, and impairments in learning and understanding social cues. Evidence from brain studies suggest that such symptoms maybe related to a deficiency of oxytocin, a natural occurring hormone derived in the hypothalamus. This study aims to investigate the efficacy of oxytocin nasal spray on improving behaviour and physical health in PWS.
Parent Education For The Treatment Of Severe Behaviour Problems In Children With Developmental Disabilities
Funder
National Health and Medical Research Council
Funding Amount
$116,220.00
Summary
Approximately 40% of children with developmental disabilities have severe behaviour problems (e.g., aggression, self-injury, property destruction, and extreme tantrums) (Einfeld and Tonge, 1996). The care of a child with such problems represents a significant burden to parents and society. One of the most promising treatments is functional communication training (FCT), which aims to reduce problem behaviours by improving the child's communication skills. Numerous studies have demonstrated the ef ....Approximately 40% of children with developmental disabilities have severe behaviour problems (e.g., aggression, self-injury, property destruction, and extreme tantrums) (Einfeld and Tonge, 1996). The care of a child with such problems represents a significant burden to parents and society. One of the most promising treatments is functional communication training (FCT), which aims to reduce problem behaviours by improving the child's communication skills. Numerous studies have demonstrated the effectiveness of FCT (Mirenda, 1997). Wacker et al. (1998) have shown that parents can be taught to use FCT, but these parents received individual consultations, which would seem to limit its practicality. Preliminary results from our current APEX grant suggest that parents can learn to implement this treatment in a group format, which is more practical from a public health perspective. However, it is currently unknown if group training is as effective as individual consultation. In the present application, we aim to compare these two ways of teaching parents how to use FCT. From a total sample of 36, the parents of 18 children will be randomly assigned to the group training format and 18 to the individual format. All parents will receive 12 hours of training on how to use FCT, either as part of a group of 3 families (mothers and-or fathers) in the clinic or on a one-to-one basis in the family home. Pre, post, and follow-up measures of problem behaviours will be used to address the research question: Is group training as effective as individual consultation? If so, we would have demonstrated a more practical way of teaching parents how to implement this evidence-based treatment for child behaviour problems.Read moreRead less
The Effect Of Very Premature Birth On Brain Development
Funder
National Health and Medical Research Council
Funding Amount
$517,975.00
Summary
The neurological outcome of the premature infant is of major importance. Approximately 2,600 premature infants weighing less than 1500 grams are born annually in Australasia. Of the approximate 2,400 survivors between 5-15% will have a more major cerebral palsy, i.e. around 200 children per annum. A greater proportion of 25-50%, i.e., upto 1200 children will have a developmental disability that will adversely affect their school perfomance requiring special assistance or repeating grades. With a ....The neurological outcome of the premature infant is of major importance. Approximately 2,600 premature infants weighing less than 1500 grams are born annually in Australasia. Of the approximate 2,400 survivors between 5-15% will have a more major cerebral palsy, i.e. around 200 children per annum. A greater proportion of 25-50%, i.e., upto 1200 children will have a developmental disability that will adversely affect their school perfomance requiring special assistance or repeating grades. With an increasing number of very prematurely born infants surviving, the absolute number of affected children will continue to rise. Prevention of these disabilities will require an understanding of the cause. The educational and social implications of these high rates of neuro-developmental disability are enormous and the focus of wide international concern. Magnetic Resonance Imaging : It is a major challenge for neonatologists to be able to understand the impact of their therapies and managements on the developing brain. A window into the newborn brain can be seen utilising advanced magnetic resonance imaging techniques in-vivo to investigate these key issues: 1. What is the nature of brain injury in the prematurely born infant? 2. What are the risk factors for brain injury in the prematurely born infant - and are they able to be altered to reduce this risk - e.g. blood pressure management, steroid therapy 3. Is the brain of a prematurely born infant different from that of a full term born infant at TERM equivalent - if so, how is it different? 4. Are there certain postnatal therapies that relate to any alteration in brain structure and chemistry - e.g. postnatal nutrition, modes of ventilation, pharmacological therapies? 5. How does the brain structure relate to function on long term neuro-developmental follow up of our infants at 2 years?Read moreRead less
Improving The Outcome Of Premature Infants- A Randomised Trial Of Preventive Care At Home
Funder
National Health and Medical Research Council
Funding Amount
$633,375.00
Summary
The high rate of adverse neurodevelopmental outcomes of very premature infants is of major concern. In Australia there are approximately 2600 very low birthweight (VLBW, birthweight <1500 g) or very premature (<30 weeks' gestational age) survivors per annum. A large proportion of these infants (40%-50%) will later develop motor incoordination, cognitive impairment, attention deficits or behavioural problems (up to 1300 new cases per year). There is little research to test the efficacy of e ....The high rate of adverse neurodevelopmental outcomes of very premature infants is of major concern. In Australia there are approximately 2600 very low birthweight (VLBW, birthweight <1500 g) or very premature (<30 weeks' gestational age) survivors per annum. A large proportion of these infants (40%-50%) will later develop motor incoordination, cognitive impairment, attention deficits or behavioural problems (up to 1300 new cases per year). There is little research to test the efficacy of early preventive care programs geared to changing the infant's environment (physical management, behavioural regulation, maternal factors). In the proposed study we aim to use a low cost preventive care program at home conducted by physiotherapists and psychologists that has been shown to have utility and efficacy in pilot work, with follow up until 2 years of age. In subsequent studies we would aim to follow this cohort to school age, to determine if there are any lasting benefits of early intervention accompanied by measures of brain growth and structural development using advanced imaging techniques. Any new health care program should result not only in improvements in health, but should be affordable to implement so an economic evaluation will also be undertaken. This study will also utilise novel and advanced MRI brain imaging techniques to understand the complex interaction between brain injury and altered brain development in these infants with the risk and the repsonse to this program of care. In this way the changes in brain connectivity, structure and biochemistry can be formally defined to undertsnad the pathway of any potential benefit from this program.Read moreRead less
Depression And Anxiety In Working Adults: The Costs And Outcomes Of Working While Ill
Funder
National Health and Medical Research Council
Funding Amount
$137,292.00
Summary
Depressive and anxiety disorders are common in the working population and costly. Individuals can continue working while ill or take an absence from work. This study will evaluate the economic cost and health outcomes of these two scenarios, using existing and published data to develop descriptive models. We consider who pays and who benefits from the perspective of the individual, their employer and society, to inform policy making, management practices, and clinical care.
Repeated Prenatal Corticosteroids: Effects On Childhood Development, Behaviour, Growth And Health
Funder
National Health and Medical Research Council
Funding Amount
$718,055.00
Summary
Infants born preterm are at high risk of needing help with their breathing to survive. Corticosteroids given to the mother prior to preterm birth can substantially reduce these risks, although the beneficial effects of these drugs only seem to last seven days. Because of this there has been a tendancy to repeat the dose of prenatal steroids after seven days in women who remain at continued risk of very preterm birth. There has been no formal assessment of whether or not repeating the dose of pre ....Infants born preterm are at high risk of needing help with their breathing to survive. Corticosteroids given to the mother prior to preterm birth can substantially reduce these risks, although the beneficial effects of these drugs only seem to last seven days. Because of this there has been a tendancy to repeat the dose of prenatal steroids after seven days in women who remain at continued risk of very preterm birth. There has been no formal assessment of whether or not repeating the dose of prenatal corticosteroids is beneficial or harmful. In this clinical trial we will test what effect, if any, repeat doses of corticosteroids given to women who remain at risk of pretermbirth, have on children at the age of two years Women are eligible for the trial if at of less than 32 weeks of pregnancy, they have received corticosteroids seven or more days ago, and they are considered to be at continued risk of preterm birth. Women are randomised to one of the two treatment groups. Half the women will receive a weekly intramuscular injection of corticosteroids up to the time of birth or 32 weeks gestation, whichever is earlier, whilst the risk of very preterm birth remains. The other half of the women will receive a saline placebo injection. Chance will decide which treatment the women receives. In this study all children who survive to 2 years corrected age will be assessed to see if they have any problems with their health, growth and development. In particular we will assess how well they can walk, talk, understand, see and hear. The trial will be able to assess whether repeat doses of prenatal corticosteroids are helpful or not for infants at risk of being born very preterm by comparing the short term effects on infant health after birth and whilst in hospital with the effects on the child's later health, growth and development. An economic assessment of repeat doses of prenatal corticosteroids will be made in these children.Read moreRead less
Direct And Indirect Assessment Of 5 Ability Structures Underlying 7 Categories Of Childhood Psychopathology
Funder
National Health and Medical Research Council
Funding Amount
$263,311.00
Summary
This research has four main aims. First, we aim to obtain detailed knowledge of how normal children develop a range of different abilities, including motor coordination, language skills, the ability to understand other people, self-control, and general cognitive ability. Second, with this knowledge of normal development we will be able to identify cases in which normal development does not occur and to identify the exact ability area(s) in which development is abnormal. Patterns of abnormal deve ....This research has four main aims. First, we aim to obtain detailed knowledge of how normal children develop a range of different abilities, including motor coordination, language skills, the ability to understand other people, self-control, and general cognitive ability. Second, with this knowledge of normal development we will be able to identify cases in which normal development does not occur and to identify the exact ability area(s) in which development is abnormal. Patterns of abnormal development will be studied in children with one of seven disorders, including Autistic Disorder, Intellectual Disability, and Developmental Coordination Disorder. Third, we will assess whether deficits in some ability correspond to impairments in just one basic psychological structure (e.g., language deficits are related to impairment in the ability to recognise sounds) or whether they can be due to impairments in several structures (e.g., the ability to recognise faces or the ability to maintain attention). Finally, we will investigate whether and how impairments in one or more basic psychological structures can result in deficits in one or more of the ability areas that are the basis for the diagnosis of one or more developmental disorders. This research is expected to lead to an enhanced ability to assess the exact nature of any given developmental disorder which, in turn, should enhance clinical care of the child.Read moreRead less