Vaccines During COVID-19, Parent-teen Communication, ASD Screening, Violence Exposure

shafere1 [at] email.chop.edu (By Emily Shafer)

This week’s In the News features updated findings by PolicyLab researchers who identified areas at high risk for a second wave of COVID-19, if social distancing guidelines are relaxed too quickly. Next, a study from the Vaccine Education Center at Children’s Hospital of Philadelphia highlights declining childhood vaccination coverage during the COVID-19 pandemic. Other headlines include research on improving parent-teen communication, and disparities in universal screening for autism spectrum disorder. Rounding out the coverage is a study about exposure to violent events and its link to behavioral disorders in adolescents.

PolicyLab Researchers Update Risk Model for Second Waves of COVID-19

Updated data from the CHOP PolicyLab’s COVID-19 model indicate that the risk for second waves of the pandemic remains low if communities implement cautious and incremental reopening plans. Areas at high risk for second waves of the outbreak are those that have relaxed social distancing quickly, such as certain counties in Texas and Southeast Florida.

David Rubin, MD, MSCE, director of PolicyLab at CHOP and a professor of Pediatrics at the University of Pennsylvania’s Perelman School of Medicine, commented on the findings in the Washington Post.

The model now includes more than double the number of counties in the original model. With this additional data, the model also indicates that rising temperatures reduce the risk for peaks of coronavirus cases in many locations, provided that communities are not aggressive in reopening.

“I’m encouraged to see that our models have been accurate — that as we predicted, many communities, including large cities, may be ready to reopen if they take a cautious and slow approach,” Dr. Rubin said. “However, we continue to caution that reducing the likelihood of additional outbreaks will require individuals and business owners to be vigilant with personal protection, wearing masks, and practicing proper hygiene, and instituting strong workplace safety measures. Unfortunately, we are already seeing some areas move too quickly and without enough vigilance.”

To learn more about the model and see the most updated data, see the PolicyLab press release.

Childhood Vaccination Coverage Declined During COVID-19 Pandemic

Angela Shen, ScD, a research scientist in the Vaccine Education Center at CHOP, co-authored a study published in Morbidity and Mortality Weekly Report that found a decline in childhood vaccination coverage during the COVID-19 pandemic.

The researchers used data from the Michigan Care Improvement Registry to evaluate vaccination status of children ages 1, 3, 5, 7, 16, 19, and 24 months. They assessed a sample of 9,269 patients for the study years 2016 to 2019, and a sample of 9,539 patients for 2020, as of May 2020.

The study team found that up-to-date vaccination status declined for all age groups, from approximately two-thirds of children from 2016 to 2019, to approximately half of children in 2020.

Dr. Shen discussed the study with The New York Times, calling the results “concerning.”

“Now, you’re not just dealing with COVID,” Dr. Shen said. “Now you’re contending with common vaccine-preventable diseases.”

Intervention for Parent-teen Communication Increased Teens’ Positive Emotions

Researchers at CHOP found that a primary care-based intervention promoting parent-teen communication decreased distress and increased positive emotions among adolescents.

Victoria A. Miller, PhD, a psychologist and director of research in the Craig-Dalsimer Division of Adolescent Medicine at CHOP, was the first author of the study, which appeared in the Journal of Pediatrics.

The intervention consisted of a booklet developed by the study team that promoted discussions between parents and teens who were CHOP primary care patients. The trial included 120 adolescents ages 13 to 15 and their parents, who were randomly assigned to receive the booklet and discussion materials, or receive no intervention.

Adolescents whose parents received the intervention reported a decrease in distress after two months, and they also reported increased feelings of happiness and calm. The researchers found that the intervention had a positive impact on teens who reported difficulty communicating with their parents before the trial.

“These findings underscore the promise of this parent-directed intervention delivered in primary care to promote parent-teen communication and adolescent health outcomes,” Dr. Miller said in a press release. “Given the evidence that parents have a significant influence on their children during adolescence, supporting healthy parent-adolescent relationships should be a critical part of adolescent preventive care.”

To learn more about the study, check out the press release.

Universal Screening for Autism Spectrum Disorder Linked to Earlier Diagnosis

A pair of studies conducted by PolicyLab at CHOP provided insight into universal screening and screening disparities for autism spectrum disorder (ASD). A summary and discussion of the findings are included in a Research at a Glance brief.

In the first study, researchers used data from approximately 26,000 patients at CHOP, which implemented universal ASD screening in 2014. They followed patients from age 16 months to ages 4 to 8 years to determine whether they were diagnosed with ASD. In the second study, they evaluated whether patients who screened positive for ASD during universal screening were receiving Early Intervention (EI) services, or had received referral for EI services, at the time of their screening. They evaluated referral rates to determine if there were disparities.

They found that 91% of CHOP primary care patients were screened for ASD. The universal screening detected about 40% of children who went on to be diagnosed with ASD; those who did screen positive were diagnosed 7 months earlier than children who screened negative. In the second study, they found that only 57% of children were referred to EI services if they screened positive for ASD. Girls, children exposed to languages other than English, and African American and Asian children were less likely to receive referrals.

“While our research raises critical questions about the accuracy and equity of a widely used ASD screening tool, early screening has a positive effect on the age at which children are diagnosed with ASD,” the researchers wrote in the brief. “We have an opportunity to address biases and remove obstacles by modifying screening processes so young children with ASD can get the care they need as early as possible, when intervention is most effective.”

Read more about the studies on the PolicyLab web site.

Exposure to Violent Events Related to Depression in Adolescents

Researchers at CHOP published findings in the Journal of Family Violence that identify how some violent events, such as bullying and maltreatment, are related to certain behavioral issues.

Rhonda C. Boyd, PhD, psychologist in the Department of Child and Adolescent Psychiatry and Behavioral Sciences, and colleagues evaluated a sample of 151 adolescents ages 12 to 18 years who were evaluated at a mood disorders program. They used cluster analysis to identify subgroups based on “web of violence” experiences.

The study team found high rates of exposure to maltreatment, peer victimization, and bullying perpetration. In the analysis, they identified two subgroups of patients: those with high exposure and those with low exposure. Those in the high exposure group had more severe depression symptoms, greater hopelessness, and more impairment. In addition, adolescents in the high exposure group demonstrated worse clinical outcomes.

“These findings further highlight the importance of a comprehensive assessment for involvement in violence when evaluating adolescents with depression,” Dr. Boyd and colleagues wrote.

Read more about the study here.

ICYMI

Catch up on our headlines from our May 8 In the News:

• Childhood Obesity Researchers Receive Chan Zuckerberg Initiative Award
• New Model Suggests Warming Weather Will Impact Spread of COVID-19
• New Study Reveals Most Serious Lawn Mower Injuries Occur in Rural Areas
• Drug Prevents Heart Damage in Children Undergoing Treatment for AML

Keep up with our news, stories, and updates in real time by following us on Twitter, Facebook, LinkedIn, or Instagram. Or subscribe to our newsletter to get an email sent every other Friday by signing up here.