Esther Son

Prevalence and Factors of Domestic Violence Among Unmarried Mothers With a Young Child

Using the first 3 waves of the Fragile Families and Child Wellbeing Study, this article examines the prevalence and factors of domestic violence among unmarried mothers with a young child. The findings indicate that the prevalence of domestic violence for mothers increased substantially in the first 3 years after the childs birth. Findings from regression analyses show that mothers who lived with the father, either as a wife or cohabiting partner, had significantly lower odds of domestic violence in the study measures than mothers who did not live with the father. However, the odds of domestic violence were not significantly different between married and cohabiting mothers. Policy implications are discussed.

Pregnancy Outcomes Among U.S. Women With Intellectual and Developmental Disabilities

The existing research on pregnancy outcomes for women with intellectual and developmental disabilities (IDD) is sparse. This study analyzed the 2010 Healthcare Cost and Utilization Project Nationwide Inpatient Sample and compared deliveries among women with IDD (n = 340) to the general obstetric population. Women with IDD had longer hospital stays and were more likely to have Caesarean deliveries in contrast to other women. Rates of adverse pregnancy outcomes were elevated for women with IDD across a range of measures, including early labor, preterm birth, and preeclampsia, and their infants were more likely to have low birth weight, even after adjusting for age, race, ethnicity, and insurance type. Targeted interventions are needed to address these deleterious outcomes.

Have Racial and Ethnic Disparities in the Quality of Health Care Relationships Changed for Children With Developmental Disabilities and ASD

The aim of this study was to determine if racial and ethnic disparities in the quality of provider interaction have changed between 2006 and 2010 for children with developmental disabilities and autism spectrum disorders (ASD). Data from the 2005/2006 and 2009/2010 National Survey of Children With Special Health Care Needs were analyzed. Results show that racial and ethnic disparities in the quality of provider interactions were substantial in both 2005/2006 and 2009/2010. Black and Latino parents were significantly less likely than White parents to report that their provider spent enough time with their child and was sensitive to the familys values. Racial and ethnic disparities in health care quality were found to be unchanged over time. Research and policy implications are discussed.

Peer Victimization Among Young Children With Disabilities Early Risk and Protective Factors

The purpose of this study was to examine the risk and protective factors of peer victimization among young children with disabilities. This study analyzed data from the Pre-Elementary Education Longitudinal Study (n =1,130) to test a path model that included child, family, and school characteristics at Year 1 and peer-relation difficulties and social skills at Year 2 to predict peer victimization among children with disabilities at Year 3. Children’s family and school factors had direct effects on children’s poorer social behaviors and language development, which had direct effects on peer-relation difficulties, which in turn increased peer victimization. Children’s prosocial skill development, facilitated by children’s receptive language ability, protects children with disabilities from peer victimization. Intervention implications are discussed.

Determinants of cervical cancer screening among women with intellectual disabilities: evidence from medical records.

Objective. We examined receipt of cervical cancer screening and determinants of screening for women with intellectual disabilities in one Southeastern state. Methods. Using medical records data from 2006 through 2010 for community-dwelling women with intellectual disabilities who were 18–65 years of age (n=163), we employed descriptive and bivariate statistics and a multivariate regression model to examine receipt of cervical cancer screening and the determinants of cervical cancer screening across womens sociodemographic and health-care provider characteristics. Results. Of women 18–65 years of age with intellectual disabilities, 55% received a Papanicolaou (Pap) test during 2008–2010, markedly below the Healthy People 2020 targets or rates of Pap test receipt of women without intellectual disabilities Women with intellectual disabilities who lived in residential facilities, those who lived in rural communities, and those who had an obstetrician/gynecologist had higher rates of receipt of care than other women with intellectual disabilities. Conclusions. Assertive measures are required to improve the receipt of cervical cancer screening among women with intellectual disabilities. Such measures could include education of women with intellectual disabilities, as well as their paid and family caregivers, and incentives for health-care providers who achieve screening targets.

Test of an intervention to improve knowledge of women with intellectual disabilities about cervical and breast cancer screening

BACKGROUND There is a critical need for evidence-based health education interventions for women with intellectual disabilities (IDs) to promote receipt of preventive health screenings. Previous research has established Women Be Healthy, an 8-week classroom-style intervention designed to teach women with IDs about breast and cervical cancer screenings, as a promising practice. However, additional research is needed to determine how to further improve screening-related knowledge gains. This study aimed to test a modified version of Women Be Healthy, Women Be Healthy 2, and compare its effectiveness in increasing knowledge gains to the original intervention. METHOD Women living in the community across one state in the United States were randomly assigned to a treatment (n = 98), delayed treatment, (n = 35), or no intervention group (n = 65). Women in the treatment group received Women Be Healthy, and women in the delayed treatment group received the modified Women Be Healthy 2. Baseline and post-intervention interviews were conducted to measure knowledge of cervical and breast cancer screening. Knowledge scores were compared across groups. RESULTS Among the nine knowledge items measured, one breast knowledge measure and one cervical knowledge measure showed statistically significant group differences; marginally significant differences were observed for two other knowledge measures. After adjusting for covariates, women who received Women Be Healthy 2 had increased knowledge overall compared with the women receiving no intervention. CONCLUSION Women Be Healthy 2 is promising, but additional efforts appear necessary to increase the knowledge women with IDs have about cervical and breast cancer screening.

Functional severity and Latino ethnicity in specialty services for children with autism spectrum disorder

BACKGROUND Children with autism spectrum disorder (ASD) experience a range of severity levels characterised as levels of support they need for everyday functioning. By this definition, greater levels of severity should warrant greater use of services and supports among children with ASD. In previous studies, Latino children with ASD in the USA have been shown to have lower access to diagnosis and treatment services than White children. However, none have examined service use in relation to severity. In this study, we examined whether there are ethnic disparities between Latino and White children with ASD in specialty autism-related services, and whether functional severity moderates the relationship between ethnicity and receipt of autism services. METHODS We used data from the Survey of Pathways to Diagnosis and Services, a supplement to the National Survey of Children with Special Health Care Needs and analysed four specialty services commonly used by children with ASD, adjusting for demographic variables. RESULTS We found that Latino children with ASD who had severe limitations received fewer specialty autism-related services than White children with similarly severe conditions. These disparities were evident despite the fact that the sample of Latino children in these data were more privileged than the general US Latino population. CONCLUSION Assertive policy initiatives are needed to address these disparities and ensure that these highly vulnerable children with severe functional limitations receive appropriate services and supports.

Accuracy of Self-Reported Cervical and Breast Cancer Screening by Women With Intellectual Disability

This study examines the accuracy of self-report of cervical and breast cancer screening by women with intellectual disability (n  =  155). Data from face-to-face interviews and medical records were analyzed. Total agreement, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Total agreement between self-report and medical record on receipt of both procedures was 75% for Pap test and 87% for mammography. Self-reported Pap tests and mammography showed >90% sensitivity, but specificity was low for both procedures (41% for Pap test, 30% for mammogram), indicating overreporting of receipt of Pap tests and mammography similar to women without disabilities. Clinicians and researchers are cautioned to corroborate self-reported data with other sources for patients and research participants with intellectual disability.

Population Estimates, Health Care Characteristics, and Material Hardship Experiences of U.S. Children With Parent-Reported Speech-Language Difficulties: Evidence From Three Nationally Representative Surveys

Purpose To provide estimates for the prevalence of parent-reported speech-language difficulties in U.S. children, and to describe the levels of health care access and material hardship in this population. Method We tabulated descriptive and bivariate statistics using cross-sectional data from the 2007 and 2011/2012 iterations of the National Survey of Childrens Health, the 2005/2006 and 2009/2010 iterations of the National Survey of Children with Special Health Care Needs, and the 2004 and 2008 panels of the Survey of Income and Program Participation. Results Prevalence estimates ranged from 1.8% to 5.0%, with data from two of the three surveys preliminarily indicating increased prevalence in recent years. The largest health care challenge was in accessing care coordination, with 49%-56% of children with parent-reported speech-language difficulties lacking full access. Children with parent-reported speech-language difficulties were more likely than peers without any indications of speech-language difficulties to live in households experiencing each measured material hardship and participating in each measured public benefit program (e.g., 20%-22% experiencing food insecurity, compared to 11%-14% of their peers without any indications of speech-language difficulties). Conclusions We found mixed preliminary evidence to suggest that the prevalence of parent-reported speech-language difficulties among children may be rising. These children face heightened levels of material hardship and barriers in accessing health care.

Community Approaches to the Siting of Psychiatric Housing

This article examines community planning and communications approaches used by mental health housing organizations in the siting process for community-based psychiatric housing. Drawing on interviews with housing administrators in 7 states, it assesses variations in the approach, content, timing, and modes of agency communications with community leaders, neighbors, and local citizens, and the association of these communications methods with initial and longer-term community responses to the site. The study provides evidence to inform practice for the development of community approaches to the siting of psychiatric housing.