Publications by authors named "Carly A McMorris"

15 Publications

  • Page 1 of 1

Feeding and eating problems in children and adolescents with autism: A scoping review.

Autism 2021 Mar 2:1362361321995631. Epub 2021 Mar 2.

University of Calgary, Canada.

Lay Abstract: Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other, broader difficulties with feeding and eating (eating disorder symptoms such as restricting food intake or preoccupation with body shape or weight and insistence on specific food presentation) are also common in autistic individuals. Here, we describe the nature and extent of feeding and eating problems in youth with autism. We found no common characteristics (such as severity of autism symptoms) that best describe autistic youth who experience problems with feeding or eating. Almost all studies we reviewed focused on problems with feeding (selective or picky eating), and only a few studies focused on eating disorder symptoms (concern with weight, shape, and/or body image). However, some researchers reported that eating disorder symptoms may occur more often in autistic individuals compared to their peers without autism. Many studies used the terms "feeding" and "eating" problems interchangeably, but understanding the difference between these problems is important for researchers to be consistent, as well as for proper identification and treatment. We suggest future researchers use "eating problems" when behaviors involve preoccupation with food, eating, or body image, and "feeding problems" when this preoccupation is absent. We highlight the importance of understanding whether feeding or eating problems are separate from autism traits, and the role of caregivers and other adults in the child's treatment. Considerations for health-care providers to assist with diagnosis and treatment are also provided.
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http://dx.doi.org/10.1177/1362361321995631DOI Listing
March 2021

Psychiatric disorders in adults with cerebral palsy.

Res Dev Disabil 2021 Apr 29;111:103859. Epub 2021 Jan 29.

Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, L1H 7K4, Canada.

Background: Cerebral palsy (CP) is one of the most common neurological conditions in childhood. Individuals with CP often experience various secondary conditions, including intellectual disability (ID), medical conditions, and psychiatric issues. A large number of youth with CP have psychiatric disorders; however, few studies have examined the prevalence of psychiatric issues in adults with CP at the population-level.

Aims: To investigate the prevalence and co-occurrence of psychiatric disorders at the population-level in adults with CP only, and adults with CP and ID.

Method And Procedures: Using clinical information from seven Canadian data sources, we conducted a retrospective cross-sectional analysis of adults with CP, with and without ID.

Outcomes And Results: Adults with CP were more likely than the general population to have a psychiatric diagnosis, independent of ID status. All psychiatric disorders were more common in individuals with CP than the general population, with the exception of addiction related disorders. In most cases, having an ID substantially increased the risk of having a psychiatric disorder.

Conclusions: Adults with CP are at heightened risk for experiencing psychiatric disorders. Current findings highlight the important role health care providers play in screening for psychiatric issues in individuals with CP.
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http://dx.doi.org/10.1016/j.ridd.2021.103859DOI Listing
April 2021

Different brain profiles in children with prenatal alcohol exposure with or without early adverse exposures.

Hum Brain Mapp 2020 Oct 13;41(15):4375-4385. Epub 2020 Jul 13.

Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.

Prenatal alcohol exposure (PAE) can alter brain development and impact mental health outcomes, and often occurs in conjunction with postnatal adversity (e.g., maltreatment). However, it is unclear how postnatal adverse exposures may moderate mental health and brain outcomes in children with PAE. T1-weighted and diffusion magnetic resonance imaging were obtained from 66 participants aged 7-16 years. Twenty-one participants had PAE and adverse postnatal exposures (PAE+), 12 had PAE without adverse postnatal exposures (PAE-), and 33 were age- and gender-matched controls unexposed to either prenatal alcohol or postnatal adversity. Internalizing and externalizing mental health symptoms were assessed using the Behavioral Assessment System for Children II, Parent-Rating Scale. ANCOVAs were used to compare mental health symptoms, limbic and prefrontal cortical volumes, and diffusion parameters of cortico-limbic white matter tracts between groups, and to assess brain-mental health relationships. Both PAE groups had worse externalizing behavior (higher scores) than controls. The PAE- group had lower fractional anisotropy (FA) in the bilateral cingulum and left uncinate fasciculus, and smaller volumes in the left anterior cingulate cortex than controls and the PAE+ group. The PAE- group also had higher mean diffusivity (MD) in the left uncinate than the PAE+ group, and smaller right anterior cingulate and superior frontal gyrus volumes than controls. These findings show different brain structure and mental health symptom profiles in children with PAE with and without postnatal adversity, highlighting the need to consider adverse postnatal exposures in individuals with PAE.
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http://dx.doi.org/10.1002/hbm.25130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502833PMC
October 2020

Different brain profiles in children with prenatal alcohol exposure with or without early adverse exposures.

Hum Brain Mapp 2020 Oct 13;41(15):4375-4385. Epub 2020 Jul 13.

Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.

Prenatal alcohol exposure (PAE) can alter brain development and impact mental health outcomes, and often occurs in conjunction with postnatal adversity (e.g., maltreatment). However, it is unclear how postnatal adverse exposures may moderate mental health and brain outcomes in children with PAE. T1-weighted and diffusion magnetic resonance imaging were obtained from 66 participants aged 7-16 years. Twenty-one participants had PAE and adverse postnatal exposures (PAE+), 12 had PAE without adverse postnatal exposures (PAE-), and 33 were age- and gender-matched controls unexposed to either prenatal alcohol or postnatal adversity. Internalizing and externalizing mental health symptoms were assessed using the Behavioral Assessment System for Children II, Parent-Rating Scale. ANCOVAs were used to compare mental health symptoms, limbic and prefrontal cortical volumes, and diffusion parameters of cortico-limbic white matter tracts between groups, and to assess brain-mental health relationships. Both PAE groups had worse externalizing behavior (higher scores) than controls. The PAE- group had lower fractional anisotropy (FA) in the bilateral cingulum and left uncinate fasciculus, and smaller volumes in the left anterior cingulate cortex than controls and the PAE+ group. The PAE- group also had higher mean diffusivity (MD) in the left uncinate than the PAE+ group, and smaller right anterior cingulate and superior frontal gyrus volumes than controls. These findings show different brain structure and mental health symptom profiles in children with PAE with and without postnatal adversity, highlighting the need to consider adverse postnatal exposures in individuals with PAE.
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http://dx.doi.org/10.1002/hbm.25130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502833PMC
October 2020

Characterizing adverse prenatal and postnatal experiences in children.

Birth Defects Res 2019 07 28;111(12):848-858. Epub 2019 Jan 28.

Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.

Background: Prenatal and postnatal adversities, including prenatal alcohol exposure (PAE), prenatal exposure to other substances, toxic stress, lack of adequate resources, and postnatal abuse or neglect, often co-occur. These exposures can have cumulative effects, or interact with each other, leading to worse outcomes than single exposures. However, given their complexity and heterogeneity, exposures can be difficult to characterize. Clinical services and research often overlook additional exposures and attribute outcomes solely to one factor.

Methods: We propose a framework for characterizing adverse prenatal and postnatal exposures and apply it to a cohort of 77 children. Our approach considers type, timing, and frequency to quantify PAE, other prenatal substance exposure, prenatal toxic stress, postnatal threat (harm or threat of harm), and postnatal deprivation (failure to meet basic needs) using a 4-point Likert-type scale. Postnatal deprivation and harm were separated into early (<24 months of age) and late (≥24 months) time periods, giving seven exposure variables. Exposures were ascertained via health records, child welfare records, interviews with birth parents, caregivers, and/or close family/friends.

Results: Nearly all children had co-occurring prenatal exposures, and two-thirds had both prenatal and postnatal adversities. Children with high PAE were more likely to experience late postnatal adversities, and children with other prenatal substance exposure were more likely to have early postnatal deprivation. Postnatal adversities were more likely to co-occur.

Conclusion: This framework provides a comprehensive picture of a child's adverse exposures, which can inform assessment and intervention approaches and policy and will be useful for future research.
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http://dx.doi.org/10.1002/bdr2.1464DOI Listing
July 2019

Organising healthcare services for persons with an intellectual disability.

Cochrane Database Syst Rev 2016 Apr 11;4:CD007492. Epub 2016 Apr 11.

Faculty of Health Sciences, University of Ontario Institute of Technology, 2000 Simcoe Street North, Oshawa, ON, Canada, L1H 7K4.

Background: When compared to the general population, persons with an intellectual disability have lower life expectancy, higher morbidity, and more difficulty finding and obtaining healthcare. Organisational interventions are used to reconfigure the structure or delivery of healthcare services. This is the first update of the original review.

Objectives: To assess the effects of organisational interventions of healthcare services for the mental and physical health problems of persons with an intellectual disability.

Search Methods: For this update we searched CENTRAL, MEDLINE, EMBASE, CINAHL and other databases, from April 2006 to 4 September 2015. We checked reference lists of included studies and consulted experts in the field.

Selection Criteria: Randomised controlled trials of organisational interventions of healthcare services aimed at improving care of mental and physical health problems of adult persons with an intellectual disability.

Data Collection And Analysis: We employed standard methodological procedures as outlined in the Cochrane Handbook of Systematic Reviews of Interventions, in addition to specific guidance from the Cochrane Effective Practice and Organisation of Care (EPOC) Group.

Main Results: We identified one new trial from the updated searches.Seven trials (347 participants) met the selection criteria. The interventions varied but had common components: interventions that increased the intensity and frequency of service delivery (4 trials, 200 participants), community-based specialist behaviour therapy (1 trial, 63 participants), and outreach treatment (1 trial, 50 participants). Another trial compared two active arms (traditional counselling and integrated intervention for bereavement, 34 participants).The included studies investigated interventions dealing with the mental health problems of persons with an intellectual disability; none focused on physical health problems. Four studies assessed the effect of organisational interventions on behavioural problems for persons with an intellectual disability, three assessed care giver burden, and three assessed the costs associated with the interventions. None of the included studies reported data on the effect of organisational interventions on adverse events. Most studies were assessed as having low risk of bias.It is uncertain whether interventions that increase the frequency and intensity of delivery or outreach treatment decrease behavioural problems for persons with an intellectual disability (two and one trials respectively, very low certainty evidence). Behavioural problems were slightly decreased by community-based specialist behavioural therapy (one trial, low certainty evidence). Increasing the frequency and intensity of service delivery probably makes little or no difference to care giver burden (MD 0.03, 95% CI -3.48 to 3.54, two trials, moderate certainty evidence). It is uncertain whether outreach treatment makes any difference for care giver burden (one trial, very low certainty evidence). There was very limited evidence regarding costs, with low to very low certainty evidence for the different interventions.

Authors' Conclusions: There is very limited evidence on the organisation of healthcare services for persons with an intellectual disability. There are currently no well-designed studies focusing on organising the health services of persons with an intellectual disability and concurrent physical problems. There are very few studies of organisational interventions targeting mental health needs and the results of those that were found need corroboration. There is an urgent need for high-quality health services research to identify optimal health services for persons with an intellectual disability and concurrent physical problem.
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http://dx.doi.org/10.1002/14651858.CD007492.pub2DOI Listing
April 2016

"Live It to Understand It": The Experiences of Mothers of Children With Autism Spectrum Disorder.

Qual Health Res 2016 06 26;26(7):921-34. Epub 2015 Nov 26.

York University, Toronto, Ontario, Canada.

Mothers of children with an autism spectrum disorder (ASD) variably experience challenges in their caregiving role. This ethnographic study examined the caregiving experiences of mothers of a young person with ASD (aged ≤25 years). Semistructured interviews were conducted with 85 mothers across three Canadian regions. A follow-up subsample of 10 mothers took part in participant observation sessions in the home and/or other environments within the community. Analysis yielded themes that depicted the following: redefining child and family aspirations, forging a shifted identity, and the need to "live it" to understand mothering a young person with ASD. Supports and services were perceived to be required but often insufficient to meet the needs. Findings identify a range of challenges, lessons learned, and a reconfigured sense of mothering. An emerging model of mothering a child with ASD is presented. Implications for practice, policy, and research are offered.
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http://dx.doi.org/10.1177/1049732315616622DOI Listing
June 2016

Spontaneous strategy use in children with autism spectrum disorder: the roles of metamemory and language skills.

Front Psychol 2015 4;6:182. Epub 2015 Mar 4.

Children's Learning Projects, Department of Psychology, York University Toronto, ON, Canada.

Metamemory, or beliefs about one's own memory capabilities, knowing what you know, and knowing what you don't know, has frequently been linked to the spontaneous use of rehearsal strategies in typically developing children. However, limited research has investigated mnemonic strategy use, metamemory, or the relationship between these two cognitive processes in children with autism spectrum disorders (ASDs). The current study examined the relative strength of metamemory knowledge and language skills as predictors of rehearsal use and memory performance in individuals with ASD. Twenty-one children with ASD and 21 children in a combined comparison group were matched on chronological and verbal mental age. Over two sessions, participants completed a serial recall task, a language measure, and a metamemory questionnaire. Children were classified as rehearsers/non-rehearsers based on behavioral observations and/or verbal reports of strategy use. As expected from previous research, the comparison group had a significantly higher proportion of rehearsers than the ASD group. However, spontaneous rehearsers performed significantly better on the serial recall task than non-rehearsers, regardless of group membership. Children in the comparison group had a higher mean total score on the metamemory questionnaire than the ASD group. However, when examined by rehearsal use, participants classified as rehearsers, regardless of diagnostic group, scored significantly higher on the metamemory questionnaire than non-rehearsers. Finally, across groups, hierarchical regression analyses identified both metamemory and language proficiency as significant predictors of rehearsal strategy use. The fact that the predictors showed the same relationship across the comparison group and the ASD group implies that metamemory and language proficiency, while separate entities, are both fundamental underlying skills contributing to the emergence of rehearsal strategies, and that the results are likely generalizable to other populations with developmental challenges.
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http://dx.doi.org/10.3389/fpsyg.2015.00182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4349056PMC
March 2015

Language proficiency and metacognition as predictors of spontaneous rehearsal in children.

Can J Exp Psychol 2014 Mar;68(1):46-58

Department of Psychology, York University.

Despite decades of research on fundamental memory strategies such as verbal rehearsal, the potential underlying skills associated with the emergence of rehearsal are still not fully understood. Two studies examined the relative roles of language proficiency and metamemory in predicting rehearsal use, as well as the prediction of metamemory performance by language proficiency. In Study 1, 59 children, 5 to 8 years old, were administered a serial recall task, 2 language measures, a nonverbal cognitive measure, and a rapid automatized naming (RAN) task. Language proficiency, RAN, and age were significant individual predictors of rehearsal use. In hierarchical regression analyses, language proficiency mediated almost completely the age → rehearsal use relation. In addition, automatized naming was a strong but partial mediator of the contribution of language proficiency to rehearsal use. In Study 2, 54 children were administered a metamemory test, a language measure, and a serial recall task. Metamemory skills and, again, language proficiency significantly predicted rehearsal use in the task. The predictive strength of metamemory skills was mediated by the children's language proficiency. The mutually supportive roles of automatized naming, language, and metamemory in the emergence of spontaneous cumulative verbal rehearsal are discussed in the context of the resulting model, along with the minimal roles of age and aspects of intelligence.
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http://dx.doi.org/10.1037/cep0000013DOI Listing
March 2014

Examining the criterion-related validity of the Pervasive Developmental Disorder Behavior Inventory.

Autism 2015 Apr 24;19(3):272-80. Epub 2014 Jan 24.

York University, Canada.

The Pervasive Developmental Disorder Behavior Inventory is a questionnaire designed to aid in the diagnosis of pervasive developmental disorders or autism spectrum disorders. The Pervasive Developmental Disorder Behavior Inventory assesses adaptive and maladaptive behaviors associated with pervasive developmental disorders and provides an age-standardized Autism Composite score. In previous research, the Pervasive Developmental Disorder Behavior Inventory has demonstrated moderate to strong reliability and validity. This study aimed to replicate and extend previous research by investigating the criterion-related validity of the Pervasive Developmental Disorder Behavior Inventory. Data from 40 children were analyzed in relation to other measures. The Pervasive Developmental Disorder Behavior Inventory adaptive scores were moderately correlated with cognitive and adaptive behavior scores as expected. However, no significant correlations were found between the maladaptive and Autism Composite scores of the Pervasive Developmental Disorder Behavior Inventory and the Childhood Autism Rating Scale. Results lead to concerns regarding the validity of some scores of the Pervasive Developmental Disorder Behavior Inventory.
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http://dx.doi.org/10.1177/1362361313518123DOI Listing
April 2015

An examination of iconic memory in children with autism spectrum disorders.

J Autism Dev Disord 2013 Aug;43(8):1956-66

Department of Psychology, York University, 4700 Keele St., Toronto, ON, M3J 1P3, Canada.

Iconic memory is the ability to accurately recall a number of items after a very brief visual exposure. Previous research has examined these capabilities in typically developing (TD) children and individuals with intellectual disabilities (ID); however, there is limited research on these abilities in children with Autism Spectrum Disorders (ASD). Twenty-one TD and eighteen ASD children were presented with circular visual arrays of letters for 100 ms and were asked to recall as many letters as possible or a single letter that was cued for recall. Groups did not differ in the number of items recalled, the rate of information decay, or speed of information processing. These findings suggest that iconic memory is an intact skill for children with ASD, a result that has implications for subsequent information processing.
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http://dx.doi.org/10.1007/s10803-012-1748-9DOI Listing
August 2013

Processing of ironic language in children with high-functioning autism spectrum disorder.

J Autism Dev Disord 2011 Aug;41(8):1097-112

Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada.

We examined processing of verbal irony in three groups of children: (1) 18 children with high-functioning Autism Spectrum Disorder (HFASD), (2) 18 typically- developing children, matched to the first group for verbal ability, and (3) 18 typically-developing children matched to the first group for chronological age. We utilized an irony comprehension task that minimized verbal and pragmatic demands for participants. Results showed that children with HFASD were as accurate as typicallydeveloping children in judging speaker intent for ironic criticisms, but group differences in judgment latencies, eye gaze, and humor evaluations suggested that children with HFASD applied a different processing strategy for irony comprehension; one that resulted in less accurate appreciation of the social functions of irony.
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http://dx.doi.org/10.1007/s10803-010-1131-7DOI Listing
August 2011

Contribution of physical fitness, cerebrovascular reserve and cognitive stimulation to cognitive function in post-menopausal women.

Front Aging Neurosci 2010 13;2:137. Epub 2010 Oct 13.

Department of Psychiatry, Faculty of Medicine, Dalhousie University Halifax, NS, Canada.

Unlabelled: Studies of the effects of physical fitness on cognition suggest that exercise can improve cognitive abilities in healthy older adults, as well as delay the onset of age-related cognitive decline. The mechanisms for the positive benefit of exercise and how these effects interact with other variables known to influence cognitive function (e.g., involvement in cognitive activities) are less well understood. The current study examined the associations between the physical fitness, cerebrovascular blood flow regulation and involvement in cognitive activities with neuropsychological function in healthy post-menopausal women.

Methods: Forty-two healthy women between the ages of 55 and 90 were recruited. Physical fitness (V˙O2 max), cerebrovascular reserve (cerebral blood flow during rest and response to an increase in end-tidal (i.e., arterial) PCO2), and cognitive activity (self-reported number and hours of involvement in cognitive activities) were assessed. The association of these variables with neuropsychological performance was examined through linear regression.

Results: Physical fitness, cerebrovascular reserve and total number of cognitive activities (but not total hours) were independent predictors of cognitive function, particularly measures of overall cognitive performance, attention and executive function. In addition, prediction of neuropsychological performance was better with multiple variables than each alone.

Conclusions: Cognitive function in older adults is associated with multiple factors, including physical fitness, cerebrovascular health and cognitive stimulation. Interestingly, cognitive stimulation effects appear related more to the diversity of activities, rather than the duration of activity. Further examination of these relationships is ongoing in a prospective cohort study.
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http://dx.doi.org/10.3389/fnagi.2010.00137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2967376PMC
July 2011

Effects of cardiorespiratory fitness and cerebral blood flow on cognitive outcomes in older women.

Neurobiol Aging 2010 Dec 27;31(12):2047-57. Epub 2008 Dec 27.

Department of Physiology & Biophysics, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada.

The mechanisms by which aerobic fitness confers beneficial effects on cognition with aging are unclear but may involve cerebrovascular adaptations. In a cross-sectional study of women from the community (n=42; age range=50-90 years), we sought to determine whether physical fitness is associated with higher cerebrovascular function, and its relationship to cognition. Main outcome measures included resting cerebral blood flow, cerebrovascular reserve, physical fitness (i.e., VO₂max) and cognition. Physically fit women had lower resting mean arterial pressure (MAP) and higher cerebrovascular conductance (CVC) than sedentary women. Overall cognition was negatively correlated with age and positively correlated with VO₂max. VO₂max was a predictor of resting CVC and MAP, and CVC and MAP when end-tidal gases were held constant at near-resting values. MAP and CVC were predictors of cognition. This study identified strong associations between physical fitness, vascular function and cognition, and provides new understanding regarding the mechanisms by which fitness positively impacts cognition with aging. The implications of this research are considerable and warrant future investigation.
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http://dx.doi.org/10.1016/j.neurobiolaging.2008.11.002DOI Listing
December 2010