key: cord-0077630-0t92zjva
authors: nan
title: AAPdN Virtual Conference – Accepted Abstracts
date: 2022-04-29
journal: J Pediatr Neuropsychol
DOI: 10.1007/s40817-022-00122-4
sha: 43bff3a9cf7f27d692c3a8e500dde601e5c10dc9
doc_id: 77630
cord_uid: 0t92zjva

nan

adults, especially older adults, who are at a higher risk for age-related neurocognitive decline. Less research is available regarding the effects of COVID-19 on children's neurocognitive functioning. Thus, this poster aims to review the scant literature on the late effects of pediatric COVID-19. Data Selection: Literature was obtained via searches of journals available in the following databases: APA PsychArticles, APA PsychInfo, ERIC, Medline, and Google Scholar using combinations of the following search terms: 'coronavirus, ' 'children, ' 'youth, ' 'adolescent, ' 'pediatric, ' 'infant, ' 'toddler, ' 'juvenile, ' or 'young adult' AND 'memory, ' 'cognition, ' 'attention, ' 'concentration, ' 'working memory, ' 'executive function, ' 'executive dysfunction, ' 'inhibition, ' 'planning, ' 'shifting, ' 'switching, ' 'verbal fluency, ' 'language, ' 'processing speed, ' 'psychomotor, ' 'visual, ' 'visuospatial, ' or 'intelligence,' AND 'neuropsychology' or 'neuropsychological.' A total of 11 peer-reviewed articles were deemed eligible for inclusion. Data Analysis: The 11 relevant articles were reviewed and synthesized. Information regarding neurocognitive functioning in children was extracted from each study. Conclusions: Overall, across all the studies, it was found that COVID-19 has impacted many domains of children's neurocognitive functioning (e.g., memory, attention, executive functioning, language, and intelligence). The literature on this topic is still emerging, and it is not yet clear if these deficits are chronic or if the functioning will return to baseline. If these deficits prove to be permanent, then future research should investigate treatment and resources to support the children both at school and at home. (Felitti et al., 1998; Oshri et al., 2020) . Harmful parenting can lead to autoimmune inflammatory reactions in children, which has been connected to autism spectrum disorder symptoms (ASD; Ohja et al., 2018; Oshri et al., 2020; Savino et al., 2020) . Research indicates numerous variables (e.g., parenting styles, neurobiological factors) impact an autistic child's attachment style (Temelturk et al., 2021) . However, there is limited literature on how the immune system affects attachment. Intentions of this commentary are to challenge the current understanding of how the autoimmune system is associated with parenting styles for children with autism. Discussion: Previous research reveals ASD symptoms influence parent burnout and reactions including overprotective and uninvolved parenting that negatively affect autistic children (Teague et al., 2018; Temelturk et al., 2021) . In addition, abusive parenting is associated with increases in autoimmune inflammatory reactions, and interactions between genes and parenting are associated with externalizing and antisocial childhood behaviors (Beijers et al., 2020; Sulik et al., 2012) . In contrast, attachment theory suggests that environmental factors directly lead to childhood behavioral disorders (Adshead, 2018; Beijers et al., 2020) . To reconcile the two opposing explanations, Sulik et al. (2012) proposed that genes influence more than predisposition for childhood mental disorders. Behaviors such as noncompliance and aggression may manifest in infancy, which may lead to inadequate or abusive parenting (Sulik et al., 2012) . Conclusion: Researchers and practitioners must consider a multifaceted approach to the relationships between parenting styles and autism symptoms. There may be a nonlinear relationship, as genetic predisposition for ASD and other disorders may lead to behaviors in infancy and early childhood that influence negative parenting, and negative parenting can result in neuroinflammation which influences the expression of ASD and other disorders. Carotenuto, M., Polito, A. N., Di Noia, S., Albenzio, M., Scarinci, A., Ambrosi, A., Sessa, F., Tartaglia, N., & Messina, G. (2020) . Analyzing the potential biological determinants of autism spectrum disorder: From neuroinflammation to the kynurenine pathway. Brain Sciences, 10(9), 631. https://doi.org/10.3390/brainsci10090631 Sulik, M. J., Eisenberg, N., Lemery-Chalfant, K., Spinrad, T. L., Silva, K. M., Eggum, N. D., Betkowski, J. A., Kupfer, A., Smith, C. L., Gaertner, B., Stover, D. A., & Verrelli, B. C. (2012) ABSTRACT Objective: Literature asserts that children with congenital heart disease are at higher-risk for autism spectrum disorder (ASD); however, researching exploring parallel COVID-19 social impacts in this population is scarce. Presented is a child with complex neurocardiac history and emerging concerns for ASD-related behaviors within the context of social isolation due to COVID-19 safety precautions. Methods: Patient is a 9-year-old monolingual, Caucasian, male with history of tricuspid atresia, transposition of the great arteries, aortic stenosis, and interrupted aortic arch type A. Patient has underwent nine corrective surgeries to date. Patient is in 4 th grade and struggling academically. Due to COVID-19 restrictions, he receives virtual asynchronous instruction at home. Patient has limited social contact with peers. Family history is notable for suspected ASD in older sister. Patient presented for outpatient neuropsychological evaluation, which included neurocognitive measures (e.g., WISC-V, DKEFS, Beery VMI, IVA-2) and parent questionnaires (e.g., BASC-3, MASC-2, Conners-3, ASRS). Behaviorally, patient presented with very limited eye contact. He demonstrated poor social reciprocity, was tangential and impulsive in conversation, and perseverated on topics of interest. Patient closely inspected visual inspect toys before engaging with them, and acted out movie scenes when engaging in pretend play. Results: Testing revealed largely intact cognitive abilities (FSIQ = 98). Significant weaknesses were exhibited in executive functioning, attention, working memory, processing speed, and language pragmatics. Psychosocial questionnaires revealed elevated concerns for aggression, inattention, hyperactivity, and executive dysfunction. Surprisingly, no concerns were endorsed regarding ASD symptomology, starkly incongruent with behavioral observations. Conclusions:This case highlights the importance of comprehensive developmental follow-up in patients with congenital heart disease particularly given social impacts of COVID-19. It will be imperative for clinicians to consider the ramifications of poor socialization, limited sameaged peer comparisons, and global psychosocial stressors when conceptualizing diagnostic impressions and providing targeted treatment recommendations for pediatric neurocardiac populations. Theoretical/Commentary Abstract Objectives: Childhood-onset obsessive-compulsive disorder (CO-OCD) is one of the most debilitating pediatric mental health disorders, and yet its etiology, presentation, and diagnosis remain poorly understood (Cervin et al., 2021; Jaspers-Fayer et al., 2017) . A growing body of research has increased understanding of neuroinflammatory and autoimmune links to CO-OCD and similar disorders, including pediatric acute-onset neuropsychiatric syndrome (PANS; Gagliano et al., 2020; Gerentes et al., 2019; Jaspers-Fayer et al., 2017; Wang et al., 2019) . Recent research suggests that children presenting with PANS may be frequently misdiagnosed with CO-OCD (e.g., Gagliano et al., 2020) . This presentation aims to call attention to the need for greater awareness of PANS and CO-OCD presentation and diagnosis among pediatric neuropsychologists and other care providers. Discussion: The diagnosis of PANS remains challenging, due in part to the varying presentation of symptomology and trajectory of disorder development (Sigra et al., 2018) . Although longitudinal studies regarding prognosis remain sparse, Leon and colleagues (2018) found that multimodality treatments resulted in complete or near-complete remission in 88% of children. In their longitudinal research on children with PANS, Gromark and colleagues (2021) found that approximately 85% of children reported significant and substantial improvement on symptom presentation after long-term treatment. In stark contrast, even with treatment, most children diagnosed with CO-OCD maintain an OCD diagnosis in adulthood (Rough et al., 2020) . Conclusion: Many children who actually have PANS are misdiagnosed with CO-OCD (Johnson et al., 2021) . Misdiagnosed children who are suffering from PANS may miss the opportunity for appropriate and effective treatment that, when delivered in a timely manner, could change the trajectory of their entire lives (Lotzin et al., 2021; Tang et al., 2021) . It is therefore vitally important to provide in-depth education on PANS and CO-OCD to neuropsychologists and other care providers, especially in hospital settings. Given that children with higher IQs have larger variabilities between index scores, the frequency of significant GAI/CPI splits was calculated based on overall GAI range consistent with the technical manual. The total sample and the ADHD group had significant GAI/CPI splits at roughly three times the expected rates seen in normal children (total sample: X 2 [1, N= 296] = 20.38, p= <0.001; ADHD: X 2 [1, N= 158] = 14.48, p= <0.001). Finally, significant differences between FSIQ and GAI were seen in children with mental health conditions; particularly, ADHD, LD, and ASD (ADHD: X 2 [1, N= 158] = 23.54, p= <0.001; LD: X 2 [1, N= 46] = 6.13, p= 0.013; ASD: X 2 [1, N= 28] = 5.25, p= 0.023). Conclusion: Significant differences in FSIQ/GAI and GAI/CPI are more commonly seen in children with mental health conditions; particularly, ADHD and LD. However, children with mood disorders without comorbid ADHD or LD did not show differences between FSIQ, GAI, and CPI. Monmouth University, West Long Branch, NJ ABSTRACT Objectives 1. To assess the presence of autism spectrum disorder (ASD) in the context of previous diagnoses of conduct disorder, social anxiety disorder and depression. 2. To provide diagnostic clarity due to multiple conflicting provider impressions. Method: The patient is a 13 year-old male receiving extensive psychological and psychiatric treatment since early childhood. Medications included Zoloft and Seroquel. He has an extensive history of being bullied and behavioral disruption. He has received individual therapy along with group dialectical behavioral therapy (DBT). Parents' main concerns were social problems, lack of response to DBT, disruptive behavior, and anxiety. Patient's providers were in conflict regarding diagnostic impression. Measures: Autism Diagnostic Observation Schedule -2nd Edition, Module 3 (ADOS-2), Wechsler Intelligence Scale for Children-5 th Edition (WISC-V), Weschler Individual Achievement Test-4 th Edition (WIAT-4), Meyers Neuropsychological Battery (MNB), Personality Assessment Inventory -Adolescent (PAI-A), Checklist for Autism Spectrum Disorder (CASD), Behavior Assessment System for Children-3rd Edition (BASC-3), parent report), Adaptive Behavior Assessment System-3 rd Edition (ABAS-3, parent report). Results: FSIQ 135, (99 th percentile). Achievement abilities were commensurate. Neuropsychological results were above average. Relative neurocognitive deficits were seen with right cerebral hemisphere abilities (perceptual estimation, visual construction/configuration, visual memory) and motor abilities. Results were consistent with ASD (MNB, Cor.=.44, Conf.=.80, ADOS-12, Comparison Score-7, Adaptive measures) in the context of a Gifted and Talented Profile, Oppositional Defiance and Generalized Anxiety. Conclusion: This case study underscores the importance of identifying ASD with children who present with complex presentations, namely with conflicting, multiple diagnoses. The diagnosis of ASD most accurately captured his overall behavior including deficits in social emotional reciprocity, limited communicative behaviors, social misinterpretation causing oppositionality, and anxiety. Knowledge regarding ASD increased the patient's insight, changed the course of treatment, properly informed his parents, and provided clarity to his medical providers.

The EEG connection between Autism and Seizure Disorders Objectives Authors Emma Grubbs, B.S. 1 emma.grubbs@bsu.edu Megan Slagel, M.A 1 Andrew S. Davis, Ph.D. 1 davis@bsu.edu connection between seizure disorders and ASD. This is particularly true for specific epilepsies such as West Syndrome, Lennox-Gastuat, and Infantile Spasms. This poster will examine the scant literature on this topic with a focus on EEGs of children with these disorders. Data Selection: A literature review was conducted of journals on the following databases: PsycINFO, PsycARTICLES, ERIC, and Medline. A combination of the following terms was used 'autism, ' 'autistic,' or 'Asperger,' with 'West Syndrome,' or 'Infantile Spasm,' or 'Lennox-Gastuat,' with 'EEG,' or 'electroencephalogram,' or 'electroencephalography,' with 'child,' or 'adolescent,' or 'pediatric,' or 'youth,' or 'infant,' or 'toddler,' with 'not genetic,' with 'not enzyme,' with 'not tuberous sclerosis.' A total of 41 articles were found, with only four related to the topic. Data Analysis: The four relevant articles were reviewed and synthesized. Articles pertaining to genetics, treatment, or enzymes were excluded from the search. No book chapters were included in the analysis. All articles were peer reviewed.

Conclusions: Although children with ASD are more likely to have a seizure disorder than their neurotypical peers, there has not been a focus on the EEGs for these particular types of seizure disorders. Current research has found a link in abnormal EEGs for those with ASD and these type of seizure disorders. In comparison, there is extensive literature for seizure disorders and other epileptic conditions. Implications for researchers and practitioners will be discussed. ABSTRACT Objectives: Being able to predict premorbid functioning is a key component of neuropsychological assessment, but the research is less wellestablished for a pediatric population. Furthermore, there is extremely limited research about the ability to predict premorbid academic functioning as compared to premorbid cognitive functioning. A significant body of research exists connecting poverty, neurological disease, and academic outcomes in children. Research showing the effects of socioeconomic status (SES) and reading in young children is robust; however, less is known about the effects of SES on math ability in children. The purpose of this literature review is to explore the current research regarding parental occupation, a predictive factor of SES, and early math ability in children. Data Selection: Articles were obtained using the following research databases: PsycINFO, PsycARTICLES, ERIC, and Medline. Combinations of the following search terms were used: "math", "mathematics", or "arithmetic" with "Parental", "Maternal", or "Paternal" with "Occupation" or "Vocation". Data Analysis: A total of 170 articles were found with only 15 related to parental occupation and math ability. Conclusions: As demonstrated by this literature review, an area of neuropsychology that needs more research focus is the predictive ability of parental occupation in early math outcomes. The current existing research seems to indicate a positive correlation between parental occupation and early math ability in children. However, research indicates part-time employment has greater effects on math ability in children than fulltime employment and employment in white-collar jobs has greater impact on early math ability. Ultimately, the research indicates that parental occupation tends to predict math ability and has greater predictive ability when school involvement remains high. Using demographic factors to predict premorbid cognitive functioning is common and the research findings on parental occupation and math will be discussed via implications for estimation of premorbid functioning. ABSTRACT Objectives: Disruptive behavior disorders (DBD) can, in part, be considered based upon the presence of callous-unemotional (CU) traits. Children with DBD and elevated CU-traits tend to display aggression, cruelty, and blunted emotional reactivity and have poor outcomes. The emotional processing of empathy may be related to limbic dysmorphology in children with DBD, which could help distinguish between types of disruptive behavior disorders. Understanding the pathology of CU traits may also have implications for the clinical treatment of DBD. This poster aims to analyze the scarce literature on this topic and examine the limbic differences between children with DBD with high and low CU traits as it relates to empathy. Data Selection: A systematic search of journals was conducted using the following databases: PsycINFO, PsycARTICLES, ERIC, and Medline. The following search terms were employed: 'conduct disorder,' 'conduct problem,' 'disruptive behavior,' or 'oppositional defiant disorder,' with 'callous unemotional traits, ' with 'levels,' or 'subtypes,' with 'amygdala,' 'hippocampus' or 'limbic,' with 'child,' 'adolescent,' 'pediatric,' 'youth,' 'infant,' 'toddler,' 'children,' or 'teenager,' with 'empathy.' Articles were included if they were published between 2017 and 2022 and peer reviewed journal articles. 11 articles were populated and retained based on relevancy. Data Analysis: The 11 pertinent articles were reviewed and amalgamated. 5 of the populated articles were relevant to 'disruptive behavior,' with 4 specifically including 'conduct disorder' and/or 'oppositional defiance disorder,' 4 to 'conduct problems,' and 2 to 'conduct disorder.' Conclusions: High CU-traits are associated with reduced connectivity of the posterior cingulate cortex (PCC), left amygdala hypoactivation, and increased anterior cingulate cortex (ACC). The neural substrates of DBD related to limbic dysmorphology may represent avenues of assessment and intervention in treating children with high CU-traits. The implications will be discussed for researchers and practitioners. ABSTRACT Objective: 15q26 deletion is a rare genetic disorder with very few documented cases to date (Benbouchta et al., 2020) . In these cases, this disorder has been associated with a wide variety of cognitive and medical outcomes depending on the amount of genetic material that was lost (O'Riordan et al., 2016) . These include impaired growth both prenatally and postnatally, intellectual and developmental delay with varied severity, microcephaly, and congenital abnormalities (Benbouchta et al., 2020; O'Riordan et al., 2016) . This case study aims to discuss the neuropsychological features and findings of one child with 15q26 deletion to aid in future treatment of children with this diagnosis. Methods: Data were collected as part of a pediatric neuropsychological evaluation at a pediatric hospital. The assessment battery included intelligence, memory, motor, processing speed, and achievement measures. Results: Data from this battery will be summarized to discuss the potential psychosocial, cognitive, and academic outcomes. We will also address needs for future research, and offer recommendations for best clinical practice when working with children who have 15q26 deletions. Conclusions: Through the advancement of pediatric medicine, the role of neuropsychological treatment is becoming more integrated in standard care for children with complex and rare neurological diagnosis. This is particularly true when considering neurogenetic disorders and their often life-long treatment. Through better research surrounding these unique cases, the practice of neuropsychological treatment can see continued advancement. Results: Pearson correlations between the SCT factor and 19 neuropsychological scores showed that only VMI, Arithmetic, and Coding significantly correlated with SCT, but correlations were small (r = −.14 to −.15, p<.01). Pearson correlations between SCT and the remaining PBS factors were all significant (r =.29-.44, p<.01), with motor incoordination being the highest.

Stepwise linear regression analysis using the neuropsychological scores showed that only Coding and VMI contributed significantly to predicting SCT (explained variance 3.5%). Stepwise linear regression analysis using the neuropsychological scores and PBS factor scores showed that motor incoordination was the most powerful significant predictor of SCT, followed by autism, depression, and inattention (explained variance 29.7%). Conclusions: Despite the term "sluggish cognitive tempo," our novel and unexpected findings demonstrate that SCT was not associated with neuropsychological measures of processing and performance speed. Only neuropsychological scores with a graphomotor component significantly correlated with and predicted SCT. On the PBS, motor incoordination was the strongest predictor of SCT, even stronger than inattention. Future research needs to include measures of incoordination and dysgraphia in order to understand the relationship between SCT and motor functioning. Objectives: Fetal alcohol spectrum disorders (FASDs) are a category of neurodevelopmental disorders caused by prenatal alcohol exposure (PAE). Children's Research Triangle (CRT) is a non-profit organization that specializes in the needs of children with PAE, trauma, and mental health concerns. CRT uses a set of evidence-based diagnostic criteria developed from research to identify FASDs, which has evolved as new literature has become more focused and cohesive. This presentation will discuss CRT's specific diagnostic criteria for FASDs and review the diagnostic processes used to facilitate differential diagnosis. Discussion: Children with FASDs present with a variety of physical and neurocognitive differences that impair their functioning throughout the lifespan. FASDs are more common than acknowledged, and often missed during psychological and neuropsychological evaluations (May et al., 2018) . Additionally, criteria used to diagnose FASDs vary across professions and settings. CRT understands FASDs as including physical and neuropsychological symptoms, with a unique pattern of dysmorphic facial features and growth delays characterizing fetal alcohol syndrome (FAS), and neurocognitive impairment accompanying both FAS and other PAE-related diagnoses. This neurocognitive impairment can include physical changes in the brain, in addition to impairment in intellectual development, attention, executive functioning, learning and memory, visual spatial skills, language, motor skills, sensory processing, socialemotional functioning, and/or adaptive skills (as shown on neuropsychological testing). Youths coming in for evaluations due to suspicion of an FASD have complex backgrounds, which may include a history of developmental and complex trauma, child welfare involvement, biological family history of serious and chronic mental health conditions, significant emotional and behavioral dysregulation, and comorbid diagnoses. Conclusions: Given that FASDs have symptoms that overlap with other neurodevelopmental and psychiatric disorders, it is important that psychologists and neuropsychologists conduct comprehensive evaluations of these individuals that include medical and neuropsychological components to facilitate diagnostic sensitivity and specificity. ABSTRACT Objectives: There is a substantial discrepancy between neuropsychological trainees intending to pursue board-certification (96.7%) and those in graduate programs that follow HCG guidelines (56.2%; Whiteside et. al., 2016). As a result, many trainees in non-traditional neuropsychology programs are often limited in their access to formal neuropsychology training and must seek extracurricular learning opportunities. Our primary objectives are to: 1) highlight the need for increased pediatric neuropsychology training opportunities reaching a broader audience and 2) outline a framework to support trainees in accessing and creating training opportunities in pediatric neuropsychology. Discussion: Currently, 44% of trainees are not enrolled in specialized neuropsychology tracks and cited limited access to didactics as one of the top three most restricting factors for career development (Whiteside et. al., 2016) . These trainees from non-traditional neuropsychology programs are uniquely suited to bridge service gaps between various child psychology subspecialties and pediatric neuropsychology. In this poster, we will provide an overview of recent works detailing guidelines for neuropsychology practicum training, supervision, and a proposed training taxonomy (Nelson et. al., 2015; Shultz et. al., 2014; Sperling et. al., 2017) . Using these emerging concepts, we will draw on our nontraditional neuropsychology training experiences, including accessing opportunities beyond the scope of our core curriculum, to compile a framework to support trainees and practicing clinicians in accessing and creating training opportunities in pediatric neuropsychology. Conclusions: We hope our recommendations will spark discussion regarding the need for increased support for trainees with diverse training backgrounds. Increased access to neuropsychology training will foster more equitable opportunities and therefore increased diversity within the field, helping to eliminate potential treatment barriers for patients. It is especially important to discuss these issues with the upcoming Minnesota Update conference, where new guidelines for training will be established. (Everington, Notario-Smull, & Horton, 2007) . Furthermore, there is research for college-aged students suggesting subtests on the Stanford-Binet Intelligence Scales, Fifth Edition (SB-5) and Scales of Independent Behavior-Revised (SIB-R) can detect malingering in participants that feigned intellectual disability (Musso et al., 2011; Barker et al., 2014; Doane & Salekin, 2009) . However, there is limited peer-reviewed literature examining if children with intellectual disabilities malinger. The purpose of this poster is to review the literature on the malingering of children with intellectual disabilities and to make recommendations for future considerations. Data Selection: A systemic search of peer-reviewed articles was conducted via the following databases: PsycINFO, PsycARTICLES, ERIC, and MEDLINE with Full Text using combinations of the following search terms: "Intellectual disability disorder" or "intellectual disability" or "IDD" or "mental retardation" and "child" or "adolescent" or "pediatric" or "infant" or "toddlers" and "malingering" or "validity testing." The search yielded a total of 43 articles and four were retained due to their discussion of people under the age of 18 with intellectual disabilities malingering. Data Analysis: The four articles were reviewed and synthesized. Results were mixed regarding cut-off scores for malingering in children with intellectual disabilities. Furthermore, the literature suggests a variety of measures are used to detect malingering in children. Conclusions: Results from the current literature are inconclusive for whether children with intellectual disabilities are capable of malingering. Furthermore, the current literature is inconclusive on whether or not the current tests detect malingering in children with intellectual disabilities across domains-ethnic, socioeconomic status, age, abilities, clinical conditions, and gender. This poster will discuss implications for researchers and practitioners. ABSTRACT Introduction: The American Academy of Pediatrics (AAP) recommends screening for all children as part of the regular well-check process (Lipkin et al., 2020) . According to the Autism and Developmental Disabilities Monitoring (ADDM) network, more children are identified as having ASD than in previous surveillance years; however, findings indicate fewer than half of the children with autism had a developmental screening recorded by 36 months (as stated by Maenner et al., 2020) , and the average age of diagnosis is four years and four months (Center for Disease Control and Prevention [CDC], 2019). Since 2016, universal screening practices were still not achieved. Pediatrician surveyed by the AAP found children were screened 23% of the time in 2002. By 2016, that number rose to 63%. Although the rates increased significantly, 37% of children missed the opportunity for early detection of a developmental deficit (Lipkin et al., 2020) . The present study aims to add to the current literature by examining differences in developmental screening practices among children with and without autism in 2018 and 2019.

Objectives: To examine current developmental screening practices based on parental report and compare those practices across children with and without autism, while specifically considering gender and age of diagnosis. Method: Archival data from the 2018 and 2019 National Survey of Children's Health, a nationally representative, cross-sectional survey, was used to compare developmental screening practices of children who were ever told their child had autism (n = 221) and without (n = 14,763) autism. Analyses were limited to children aged 9 months to 5 years except when calculating the mean age of autism diagnosis, which included all children birth to 17 years (n = 1,576). Results: Among children without autism, 37% received developmental screenings compared to 66% of children with autism, χ 2 (8) = 247, p < .001. Overall, males were more likely to be screened than females, χ 2 (4) = 18, p < .001. There was not a statistically significant association between gender and screenings for children with autism, χ 2 (4) = 6.93, p = .14; however, there was a statistically significant association for children without autism, χ 2 (4) = 17, p = .002. Participants with autism were diagnosed at a mean age of 5.17 years (M =5.17, SD 3.30). Conclusions: The present study revealed that 37% of children without autism and 66% of children with autism received a developmental questionnaire. When gender was considered for both children with and without autism combined, males were more likely to receive a questionnaire. When considering gender of children without autism alone, males were also more likely to receive a questionnaire. Although these results were statistically significant, they were not clinically meaningful due to small effect sizes.

Further, receiving an autism diagnosis occurred at the mean age of 5.17. Given that early intervention has repeatedly been identified as imperative to improving the quality of life for individuals with ASD, all pediatric providers have a duty to adhere to best practices for screening to decrease the age of autism diagnosis and improve the likelihood of early intervention.

changes, yet relatively intact neuropsychological scores following COVID encephalitis. Participants/Methods: Patient is an 11-year-old Hispanic female whose premorbid status was a medically healthy honor student. She was hospitalized due to COVID-19 with pneumonia and later re-admitted to ICU with altered mental status, abnormal EEG, elevated CSF protein and white cells, and encephalitis. She had residual memory complaints (repeatedly forgetting why she was hospitalized), odd social behavior, increased sleep, and intermittently acting like an infant. Her neurologist consulted us one-year after initial illness due to ongoing concerns. Comprehensive neuropsychological evaluation included WISC-V, CVLT-C, RCFT, W R A T -V , B e e r y B u k t e n i c a , G r o o v e d P e g b o a r d , a n d socioemotional questionnaires. Results: Despite significant functional difficulties, testing revealed largely intact cognitive skills, except for weak word generation and elevated anxiety. She demonstrated low average intellectual skills, with intact verbal retention across a modest time span. Strong reasoning abilities, working memory, and processing speed were inconsistent with a brain injury; by contrast, crystallized intelligence, which tends to be resilient to injury, was considerably weaker and thus discordant with her academic history. Neuropsychological profile analysis, and the pattern and timing of behavioral changes, offers significant evidence that her presentation stems largely from psychological trauma triggered by acute medical complications.

Conclusions: This case highlights the importance of examining both functional and structural considerations, regardless of the presumptive etiology. Without understanding the true nature of their underlying problem, a child may not receive the appropriate remedial treatment. While most brain-injured patients are likely to suffer some loss of neurological integrity, many have additional psychological injuries that must be carefully assessed. ABSTRACT Objective: Congruent with findings on social impairments in children with autism (ASD) (Lozier et al.) , the NEPSY-II Affect Recognition (AR) subtest was designed for ASD assessment (Korkman et al, 2007) . However, since normative data provides little insight into response patterns, we used clinical data to examine ASD differences on item 17, the starting point for children >7, which contains particularly ambiguous affect. Method: We retroactively reviewed 33 neuropsychological evaluations of patients ages 6-16 (M age : 8.79, SD=2.71; 67% male; 89% Caucasian). 55% of subjects were diagnosed with ASD, while 61% and 36% were diagnosed with ADHD and learning disability, respectively. Our primary outcomes were reversal at AR item 17 (yes/no code) and selected answer choice for 17 (17 Ans). We computed correlations between ASD and the outcome variables, as well as with all variables with <30% missing values to explore other associations. Results: Contrary to our hypothesis, there was no significant difference between ASD groups on the outcome variables. However, when ASD and ADHD were merged into a neurodevelopmental disability (ND) category, 80% of subjects in this group reversed on item 17 and significantly differed on 17 Ans (p=0.05), with 69% of the ND group selecting #1. Moreover, hyperactivity measured by parent ratings on the Behavior Assessment System for Children was correlated with missing the target item (p=0.01) for the ASD group. Conclusions: The target item was missed by most of the sample regardless of diagnosis, and it is possible that parent-reported hyperactivity may have contributed. Those with a neurodevelopmental disability were more likely to choose #1, which depicts a primary emotion (i.e., anger) with similar valance to the secondary emotion in the stimulus (i.e., disgust; Kemper 1987). Limitations include a small heterogeneous sample size lacking diversity. Future research should explore affect recognition relative to emotion valance in this population. ABSTRACT Objectives: Nearly 90% of diagnosticians report assessing autism in females is more difficult than assessing males (Tsirgiotis, et. al, 2021) , possibly resulting in overdiagnosis of males or underdiagnosis of females. Diagnostic difficulties may also contribute to sex disparities seen in the literature, such as the 3:1 ratio of ASD in males versus females (Loomes, Hull, Mandy, 2017) . Diagnosticians generally use in-person assessment models which can be influenced by social biases. This study investigated diagnostic outcomes between sexes using a hybrid model. Methods: Chi-squared statistic was used to examine the relation between sex (male or female) and diagnostic outcomes (ASD diagnosis or no ASD diagnosis). The sample had 119 patients ages 3-21 years (68.1% male; 31.9% female) from a private clinic. Overall, 66 patients were referred by a professional and 53 self-referred. We hypothesized there would be a difference in rate of diagnosis between sexes, with males being diagnosed more than females. Results: Overall, 69 males and 33 females were diagnosed with ASD versus 12 males and 5 females not diagnosed. Results of the chi-square statistical analysis showed there was no significant association between sex and diagnostic outcome, X 2 (1, N = 119) = .058, p = .810. Females were just as likely to be diagnosed with ASD. Conclusions: While sex differences were present in rates of referral, results indicate females were as likely to be diagnosed with ASD as males (i.e., sex had no relationship with the diagnostic outcome of referred clients). A hybrid model may aid in reducing bias as this approach is data-driven and relies less on clinician intuition. A hybrid model using a team approach allows for input from multiple providers. In future research, it may be useful to parse out sex disparities in diagnostic outcomes related to screening methods and referral rates as opposed to clinician expertise. ABSTRACT Objectives: Females may present with non-stereotypical features of ASD and camouflage deficits more than males (Schuck, Flores, & Fung, 2019) , making the diagnostic process more difficult. The objective of this study was to review diagnostic challenges of a female patient with ASD. Investigating the complexities of this case may increase awareness of autism presentation in females and difficulties involved in the diagnostic process. Case History: Patient is a 21-year-old, Caucasian female, self-referred for an autism evaluation. She reported several previous psychological evaluations resulting in 14 different diagnoses, none of which she believed explained her experiences. No previous evaluations addressed the possibility of ASD. Through her own research, the patient determined ASD to be an appropriate diagnosis to rule-out, and sought an evaluation accordingly. The patient completed an autism evaluation with a private clinic, which utilized a hybrid telehealth model. Patient remotely completed intake forms, SCQ, and ABAS-3. She completed MIGDAS-2 and an audio/video recorded ADOS-2 in-person. All collected data was uploaded for psychologist(s) to review for diagnosis and treatment planning. Results: The case was reviewed by four clinicians. Two determined the patient met full diagnostic criteria for ASD, one determined she did not, and the last clinician agreed with the ASD diagnosis only after a second review of the data. The conflicting clinical judgments centered around diagnostic criteria A and difficulty parsing through symptoms related to possible comorbid conditions (e.g., anxiety and depression).

Conclusions: This case study demonstrated the complexities of the diagnostic processes for adult females receiving an ASD evaluation and diagnosis. Symptoms appeared subtle and often were camouflaged by learned compensatory behavior. MIGDAS-2 proved valuable in exposing social deficits. The two clinicians trained in MIGDAS-2 were able to diagnose the patient upon first review. Future research may study the most efficacious diagnostic tools for young-adult females.

References Schuck, R. K., Flores, R. E., & Fung, L. K. (2019). Brief report: Sex/gender differences in symptomology and camouflaging in adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 49 (6) ABSTRACT Research has highlighted delays in identification of minoritized children for speech-language services compared to their white counterparts. The present study explores associations between race/ethnicity, retention, and the diagnosis of language disorder (LD) in school-aged children and adolescents from low-income, ethnically diverse backgrounds. The retrospective study collected demographic and post-diagnostic information from the charts of 355 students who received a neuropsychological evaluation at an urban outpatient clinic between 2015 and 2020. Participants (males=228;Mage=10.45,SD=3.35) were referred due to consistently poor school performance concerns. Of 355 charts reviewed, 156 included participants' race/ethnicity (3.8% white, 51.3% Hispanic/Latinx, 5.8% Asian, 28.2% Black, 10.9% multiracial/multiethnic). As a result of a neuropsychological evaluation, 87.8% of children were provided different diagnoses than upon entry. Analyses revealed a relationship between ethnicity and the diagnosis of LD as principal challenge (X 2 (4,156)=18.474,p<.01); 43.8% of Hispanic/Latinx children were diagnosed as opposed to smaller percentages within the Black (15.9%), white (0.0%), Asian (11.1%), and multiracial/multiethnic (11.8%) samples. Analyses also revealed a relationship between retention and ethnicity (X 2 (4,151)=10.068,p=.04); higher percentages of Black (33.3%), Hispanic/Latinx (32.1%), and Asian (22.2%) children were retained than white (0.0%) and multiracial/multiethnic (0.0%) counterparts. When comparing retention rates and LD (X 2 (4,151)=11.391,p<.01), it was observed that 48.8% of retained children were provided an LD diagnosis as a primary concern in contrast to 20.9% of promoted children. Crosstabulation of the relationship between retention, race/ethnicity, and LD as primary diagnosis was significant for the Hispanic/Latinx (X 2 (1,151)=4.029,p=.05) and Asian (X 2 (1,151)=3.938,p=.05) samples; no significance was noted for the Black sample. Prior research has elucidated negative impacts of grade retention and poor identification rates of SLI, notably in Hispanic/Latinx populations. Our results contribute to literature regarding the complex interplay between retention, race/ethnicity, and occurrence of LD, suggesting need for improved screening practices, evaluation of referral bias, and evidence-based interventions for language-based weaknesses generally, and particularly for Hispanic/Latinx communities. 

The increasing prevalence of autism spectrum disorder (ASD) has led researchers and clinicians to evaluate the efficacy of traditional (e.g., applied behavior assessment) and novel interventions. Music education offers children a myriad of benefits beyond simply learning music, and research is emerging to show that it offers the same for children with ASD. Pediatric neuropsychologists should be aware of the research on this as music education may provide evidence-based interventions for the symptomology associated with ASD. This poster will review the existing literature on the efficacy of music education in the schools to address ASD symptomology and improve outcomes for these children. Data Selection: Literature was obtained through searches in the following databases: PsycINFO, PsycARTICLES, ERIC, and MEDLINE with Full Text. The searches used a combination of the following terms: 'music education or 'music learning' or 'music teaching' or 'music class' with 'autism' or 'asd' or 'autism spectrum disorder' with 'school' or 'schools'. After the search, a total of 33 articles were found with only 13 relevant articles. Data Analysis: The 13 relevant articles were reviewed and synthesized. Articles were not considered that focused on the practice of music therapists, improving music teachers' knowledge of ASD and/or how to improve teaching of these children. We also did not consider articles that focused primarily on neural processing differences in music. Conclusions: Although schools routinely provide music education for children with ASD, there appears to be limited literature regarding the effectiveness of this as intervention for children with ASD. This would seem to be an oversight as the literature suggests it can help children develop neurocognitive processing, foster social skills, develop joint attention, reduce ASD symptomology, and increase physical activity which is important for addressing the physical health of children with ASD. The implications for researchers and practitioners will also be discussed. ABSTRACT Education and pediatric neuropsychology have consistently had a unique relationship. Neurocognitive development, to some degree, has been linked to a child's ability to access education and have educational supports that appropriately meet their needs (Greenberg, et al., 2004; Noble, et al., 2005) . This field also has a longstanding history in providing academic recommendations and intervention to improve a child's overall neurocognitive development and functioning (Hartlage & Telzrow, 1983; Witsken, et al., 2008) . Certain teaching styles have even been historically contrived and prescribed in order to better serve the needs of the student (Craney, 1989) . More recent guidance has continued to use neuropsychology and childhood brain research as a way to shape education (Bergen & Woodin, 2017) . It is important to note that due to the novel coronavirus pandemic (COVID-19) , all educational systems were impacted to some degree (Mseleku, 2020) . There has been a highly disparate response to COVID-19 in different areas, with responses ranging from continued remote learning to other schools returning to entirely in-person learning without mask restrictions (Margolius, et al., 2020) . Taken together, it is very likely that a child's cognitive development has been impacted by the major shift in academic support caused by COVID-19. In this literature review, the authors will explore the historical context of neuropsychology's role in the classroom and academic involvement, the impact of COVID-19 on education, learning styles, and classroom intervention, as well as the potential outcome on the child's overall neurocognitive development. The authors will then delineate the clinical implications for pediatric neuropsychology, especially highlighting the recommendations which can be provided to improve a child's learning ability and to assess a child's neurocognitive ability more appropriately in the era of telehealth. Finally, the authors will present research implications including the development of greater e-learning and e-teaching supports for children, teachers, and families.

or 'math ', or 'writing', or academic', or 'neuropsychological', or 'neuropsychology' . A total of 47 articles were identified and only 14 were somewhat relevant to pediatric neuropsychology and cerebellar pediatric pilocytic astrocytoma. Data Analysis: The 14 relevant articles were reviewed and synthesized. Conclusions: Despite the relatively common occurrence of cerebellar research on Pediatric Pilocytic Astrocytoma, the field of neuropsychology does not have a definitive conclusion for cognitive functioning outcomes of PA survivors. For instance, outcomes range from prolonged impairment to complete recovery of cognitive impairments. While using less restricted search terms can extend the understanding of pediatric pilocytic astrocytoma for the field of pediatric neuropsychology, more focus is needed on cognitive impairment outcomes from various treatments.

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Involvement of fear, incompleteness, and disgust during symptoms of pediatric obsessive-compulsive disorder

Pediatric acute-onset neuropsychiatric syndrome: A data mining approach to a very specific constellation of clinical variables

Obsessive-compulsive disorder: Autoimmunity and neuroinflammation

A two-to-five year follow-up of a pediatric acute-onset neuropsychiatric syndrome cohort

Prevalence of acute-onset subtypes in pediatric obsessive-compulsive disorder

Anti-inflammatory, antibacterial and immunomodulatory treatment in children with symptoms corresponding to the research condition PANS (pediatric acute-onset neuropsychiatric syndrome): A systematic review

Longitudinal outcomes of children with pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS)

Risk and protective factors, stressors, and symptoms of adjustment disorder during the COVID-19 pandemic -First results of the ESTSS COVID-19 pan-European ADJUST study

Screening for pediatric obsessive-compulsive disorder using the obsessive-compulsive inventory-child version

Treatment barriers in PANS/PANDAS: Observations from eleven health care provider families

Systemic autoimmune diseases are associated with an increased risk of obsessive-compulsive disorder: A nationwide population-based cohort study. Social Psychiatry and Psychiatric Epidemiology

Promoting optimal development: Identifying infants and young children with developmental disorders through developmental surveillance and screening

Prevalence of autism spectrum disorder among children aged 8 years -autism and developmental disabilities monitoring network, 11 sites, united states

A Neuropsychological Consultation Model Designed To Foster Wholebrain and Cognitive Style-Responsive Instruction for

The PATHS curriculum: Theory and research on neurocognitive development and school success

The neuropsychological basis of educational intervention

A literature review of E-learning and E-teaching in the era of Covid-19 pandemic

Neuroscience perspectives on disparities in school readiness and cognitive achievement. The Future of Children

Leading educational change using a neuropsychological Response-to-intervention approach: Linking our past, present, and future

Title Pediatric neuropsychology and the indigenous American people Authors Katie A

47306 Office Phone

Parent and clinician agreement regarding early behavioral signs in 12-and 18-month-old infants at-risk of autism spectrum disorder

Combining parent and clinician ratings of behavioural indicators of autism spectrum disorder improves diagnostic classification

Teachers College

Neurological abnormalities have also been reported in approximately 36% of all COVID-19 patients. The cellular receptor angiotensin-converting enzyme 2 (ACE2) is required for SARS-CoV-2 to enter human cells, and a high concentration of this is found in the brainstem, thalamus, middle temporal gyrus, motor cortex, circumventricular organs, olfactory bulb, and posterior cingulate cortex. This finding suggests SARS-CoV-2 can readily enter cells of these regions, but this assumption needs to be supported by more data. While there are a growing number of studies investigating the neurological manifestations of COVID-19 in adults, relevant pediatric research is still scarce. This poster aims to review early findings of neurological abnormalities associated with COVID-19 in children. Data Selection: Literature was obtained by searching of journals in the following databases: PsycARTICLES, PsycINFO, ERIC, and Medline. The following search terms were used in combinations: 'child,' 'adolescent,' 'youth,' 'pediatrics,' 'infant,' or 'toddler,' with 'covid-19,' 'coronavirus,', or 'covid-19 and multisystem inflammatory syndrome in children

Conclusions: Pediatric COVID-19 has been associated with acute disseminated encephalomyelitis (ADEM)-like changes, white matter hyperintensities, hypometabolism in cerebellum, brainstem, and temporal regions, and restricted diffusion in brain. In children with COVID-19-associated MIS-C, splenial lesions in corpus callosum, encephalopathy with reversible splenial lesion (MERS), and posterior reversible encephalopathy syndrome (PRES) were reported. As most of the findings were drawn from case studies, large sample and longitudinal research is needed in the pediatric COVID-19 research. 28 Title Reviewing the Cognitive Outcomes in Cerebellar Pediatric Pilocytic Astrocytoma Authors Keldyn L

A review of the literature suggests disparate outcomes in cognitive functioning for children with PA. For example, in addition to premorbid factors, the literature suggests different treatment plans can lead to different neurocognitive outcomes. The aim of this poster is to review the literature on Pediatric Astrocytoma and understand the cognitive sequelae. Data Selection: Literature was acquired through searches of journals available in the following databases: PsycINFO, PsycARTICLES, ERIC, Medline, and Psychology and Behavioral Sciences Collection. Combinations of the following search terms were used during the literature search: 'Pilocytic Astrocytoma' with 'child', or 'adolescent', or 'youth', or 'infant', or 'toddler', or 'pediatric', and 'Cerebellum', or 'Cerebellar', and 'cognitive', or 'intellectual', or 'executive

ABSTRACT Objectives: A wealth of research has demonstrated that culture accounts for a significant part of the variance in neurocognitive tests scores. Additionally, understanding a patient's culture is essential to determining whether or not they meet the diagnostic criteria for psychiatric disorders. As such, the lack of research for indigenous American people, especially indigenous American children, in the pediatric neuropsychological literature is a concern. The purpose of this literature review and poster is to review the current literature on the development of intersectional cross-cultural partnership between the field of pediatric neuropsychology and the indigenous American people. Data Selection: Literature was collected through searches of academic journals through PsycInfo, PsycArticles, Medline, and ERIC. Search terms used in data selection included 'indigenous American', or 'indigenous people ', or 'native American', or 'American Indian', with 'neuropsychology', or 'neuropsychological assessment', with 'adolescent', or 'child', or 'children', or 'infant', or 'pediatric', or 'teenager', or 'youth' . A total of 48 articles fit the search term criteria. After filtering out unrelated research, 13 articles remained. Data Analysis: The 13 remaining articles were analyzed and synthesized. These 13 articles cover topics ranging from addressing the lack of neuropsychology research pertaining to the indigenous American population, the need to address health disparities in indigenous American communities, intergenerational trauma, cultural variables, historical disenfranchised grief, and historical unresolved trauma through cultural genocide. Conclusions: Despite the many conversations about cultural humility and past failures to challenge racism happening in the psychology community today, there is insufficient literature in the field of pediatric neuropsychology about working with indigenous American children. The present literature review did not yield any factorial invariance studies on any measures commonly used in pediatric neuropsychology. It is important to consider that indigenous Americans are not a homogenous group. Implications for researchers and practitioners will be discussed. ABSTRACT Objective: Parent reports of behavioral concerns have been found to be more informative than clinician ratings (Sacrey et al., 2018) . Informant differences may influence the identification of autism spectrum disorder (ASD; Ward et al., 2018) . Ward et al. (2018) noted that clinicians are typically more reliable in reporting symptomology within the social communication, while parents more accurately report behavioral data. Therefore it is important to understand the relationship between clinician and parental report in order to accurately integrate data in ASD evaluations. This poster compares parent and clinician ratings of behaviors related to autism spectrum disorder (ASD) in a group of infants at high risk for ASD. Method: This study examines pre-test data from a University/Pediatric Hospital collaborative program aimed at identifying infants and toddlers at high risk for developing autism spectrum disorder (ASD). Participants were accepted for participation if they have a sibling diagnosed with ASD or if their parent/pediatrician noted developmental concerns. Sixteen infants (mean age: 11.25 months, n = 5 females) participated. Clinicians completed the Autism Observation Scale for Infants (AOSI) and Mullen Scales of Early Learning (Mullen), while parents completed the Autism Parent Screen for Infants (APSI), Developmental Profile-3 (DP-3), and Vineland. Results: Data from clinician-completed AOSI and Mullen were compared to parent-completed APSI, DP-3, and Vineland-3. Total scores and scales were compared based on the rater. Conclusion: The use of multiple informants is needed for gold-standard assessments. It is important to understand the relationship between raters and how that relates to the overall results of the assessment.