Publications by authors named "Paige Cervantes"

19 Publications

  • Page 1 of 1

Changes in Attitudes and Knowledge after Trainings in a Clinical Care Pathway for Autism Spectrum Disorder.

J Autism Dev Disord 2020 Nov 17. Epub 2020 Nov 17.

Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone, New York, NY, 10016, USA.

Caring for individuals with autism spectrum disorder (ASD) can be complicated, especially when challenging behaviors are present. Providers may feel unprepared to work with these individuals because specialized training for medical and social service providers is limited. To increase access to specialized training, we modified an effective half-day ASD-Care Pathway training (Kuriakose et al. 2018) and disseminated it within five different settings. This short, focused training on strategies for preventing and reducing challenging behaviors of patients with ASD resulted in significant improvements in staff perceptions of challenging behaviors, increased comfort in working with the ASD population, and increased staff knowledge for evidence-informed practices. Implications, including the impact of sociodemographic characteristics on pre/post changes, and future directions are discussed.
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http://dx.doi.org/10.1007/s10803-020-04775-yDOI Listing
November 2020

Trends Over a Decade in NIH Funding for Autism Spectrum Disorder Services Research.

J Autism Dev Disord 2020 Oct 10. Epub 2020 Oct 10.

Department of Child and Adolescent Psychiatry, NYU Langone Health, New York, NY, USA.

Investments in autism spectrum disorder (ASD) research, guided by the Interagency Autism Coordinating Committee (IACC), have focused disproportionately on etiology over a well-established stakeholder priority area: research to improve accessibility and quality of community-based services. This study analyzed National Institutes of Health ASD services research funding from 2008 to 2018 to examine funding patterns, evaluate the impact of IACC objectives, and identify future directions. Approximately 9% of total funds were allocated to services research. This investment remained relatively stable across time and lacked diversity across domains (e.g., area of focus, ages sampled, implementation strategies used). While advancements were observed, including increased prevalence of projects focused on adult samples and on dissemination/implementation and prevention areas, greater investment in service research is critically needed.
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http://dx.doi.org/10.1007/s10803-020-04746-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035332PMC
October 2020

Staff Perceptions and Implementation Fidelity of an Autism Spectrum Disorder Care Pathway on a Child/Adolescent General Psychiatric Inpatient Service.

J Autism Dev Disord 2021 Jan;51(1):158-168

Department of Child and Adolescent Psychiatry, Child Study Center, Hassenfeld Children's Hospital at NYU Langone, One Park Avenue, 7th Floor, New York, NY, 10016, USA.

While youth with autism spectrum disorder (ASD) are psychiatrically hospitalized at high rates, general psychiatric settings are not designed to meet their unique needs. Previous evaluations of an ASD-Care Pathway (ASD-CP) on a general psychiatric unit revealed sustained reductions in crisis interventions (intramuscular medication use, holds/restraints; Cervantes et al. in J Autism Dev Disord 49(8):3173-3180, https://doi.org/10.1007/s10803-019-04029-6 , 2019; Kuriakose et al. in J Autism Dev Disord 48(12):4082-4089, https://doi.org/10.1007/s10803-018-3666-y , 2018). The current study investigated staff perceptions of the ASD-CP (N = 30), and examined rates of ASD-CP implementation fidelity in relation to patient outcomes (N = 28). Staff identified visual communication aids and reward strategies as most helpful. The number of days of reward identification early in the inpatient stay was associated with fewer crisis interventions later in a patient's stay.
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http://dx.doi.org/10.1007/s10803-020-04509-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034489PMC
January 2021

Evaluation of a Web-Based Training Model for Family Peer Advocates in Children's Mental Health.

Psychiatr Serv 2020 May 8;71(5):502-505. Epub 2020 Jan 8.

Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York (Horwitz, Cervantes, Kuppinger, Hoagwood); McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, New York (Quintero, Cleek); Families Together in New York State, Albany (Burger); Division of Integrated Community Services for Children and Families, New York State Office of Mental Health, Albany (Lane, Bradbury).

Objective: The aim of this study was to compare knowledge gains from a new online training program with gains from an existing in-person training program for family peer advocates.

Methods: Data were used from a pre-post study of individuals who enrolled in the Web-based Parent Empowerment Program training; 144 participants completed the training and pre-post tests, and 140 were admitted to the analyses. Knowledge was assessed with 34 questions, 29 of which were common to the online and in-person trainings. Pre-post knowledge scores were available from the in-person training.

Results: Statistically significant gains in knowledge were found with both the 34 questions and the 29 questions common to both trainings. Knowledge gains across the two training models did not differ.

Conclusions: Data on knowledge gains from this accessible, affordable online model show promise for training the growing and important workforce of family peer advocates.
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http://dx.doi.org/10.1176/appi.ps.201900365DOI Listing
May 2020

Sustainability of a Care Pathway for Children and Adolescents with Autism Spectrum Disorder on an Inpatient Psychiatric Service.

J Autism Dev Disord 2019 Aug;49(8):3173-3180

Department of Child and Adolescent Psychiatry, Child Study Center, Hassenfeld Children's Hospital, NYU Langone Health, New York, NY, USA.

Children with autism spectrum disorder (ASD) are frequently hospitalized within general psychiatric settings, which are not usually designed to meet their needs. An initial evaluation of a care pathway developed for youth with ASD receiving services in a general psychiatric inpatient unit (ASD-CP) showed promise in improving outcomes while using few resources (Kuriakose et al. in J Autism Dev Disord 48:4082-4089, 2018). As sustainability of inpatient psychiatric initiatives is imperative but rarely investigated, this study examined the stability of ASD-CP outcomes during an 18-month follow-up period (n = 15) compared to the 18-month initial evaluation (n = 20) and 18-month pre-implementation (n = 17) periods. Decreased use of crisis interventions, including holds/restraints and intramuscular medication use, was sustained in the 18 months after the initial implementation period. Implications and limitations are discussed.
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http://dx.doi.org/10.1007/s10803-019-04029-6DOI Listing
August 2019

Gender Differences and Similarities: Autism Symptomatology and Developmental Functioning in Young Children.

J Autism Dev Disord 2019 Mar;49(3):1219-1231

Child Study Center, Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital, NYU Langone Health, New York, NY, USA.

A growing body of research suggests that symptoms of autism spectrum disorder (ASD) may present differently in males and females. This study examined gender differences in ASD symptoms and developmental functioning, using the Baby and Infant Screen for Children with aUtism Traits, Part 1 (BISCUIT-Part 1) and the Battelle Developmental Inventory, 2nd Edition (BDI-2), amongst children aged 17-37 months meeting ASD diagnostic criteria (n = 1317). No gender differences were found in regards to overall symptom severity or symptom domains on the BISCUIT-Part 1 when gender groups were matched by cognitive ability. Females with ASD had greater motor deficits and less communication impairment compared to their male counterparts as measured by the BDI-2. Secondary analyses examining item endorsement patterns were also conducted. Implications of the findings are discussed.
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http://dx.doi.org/10.1007/s10803-018-3819-zDOI Listing
March 2019

Does an Autism Spectrum Disorder Care Pathway Improve Care for Children and Adolescents with ASD in Inpatient Psychiatric Units?

J Autism Dev Disord 2018 Dec;48(12):4082-4089

Department of Child and Adolescent Psychiatry, Child Study Center, Hassenfeld Children's Hospital at NYU Langone Health, 1 Park Avenue, 7th Floor, New York, NY, 10016, USA.

Youth with autism spectrum disorder (ASD) are psychiatrically hospitalized at high rates. Though specialized psychiatric units are effective, few specialized units exist. The ASD Care Pathway (ASD-CP) was developed as a scalable approach to improving care in general psychiatric units through staff training and a package of autism-specific intervention strategies. An evaluation of the effectiveness of the ASD-CP in a public hospital child psychiatric service compared 18 months (n = 17) versus 18 months (n = 20) post implementation. Average length of hospital stay decreased 40% (22.4-13.4 days) and use of crisis interventions decreased 77% (holds/restraints; 0.65/day to 0.15/day), though each result only approached statistical significance (p = 0.07; 0.057). This study provides preliminary evidence for improved outcomes after implementation of an ASD-CP.
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http://dx.doi.org/10.1007/s10803-018-3666-yDOI Listing
December 2018

An abbreviated scoring algorithm for the baby and infant screen for children with autism traits.

Dev Neurorehabil 2017 Jul 11;20(5):287-293. Epub 2016 Aug 11.

a Department of Psychology , Louisiana State University , Baton Rouge , LA , USA.

Purpose: Autism spectrum disorder (ASD) screening is recommended for all children aged 18-24 months. However, healthcare providers may be burdened with the responsibility of conducting these screens in addition to necessary services. Therefore, developing a time-efficient screener with sound psychometric properties is essential.

Methods: This study sought to update the abbreviated scoring algorithm of the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT) and increase its clinical utility. Six thousand and three children with ASD or atypical development enrolled in an early intervention program participated.

Results: A 6-item algorithm with a cutoff score of 3 was found to be optimal and yielded a sensitivity of 0.960 and a specificity of 0.864.

Conclusion: Sensitivity and specificity estimates were similar to that of the complete BISCUIT-Part 1; thus, the 6-item algorithm can reliably differentiate children at-risk for ASD requiring further assessment. The algorithm appears to be a promising tool for early identification.
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http://dx.doi.org/10.1080/17518423.2016.1211189DOI Listing
July 2017

Autism spectrum disorders: management over the lifespan.

Expert Rev Neurother 2016 11 30;16(11):1301-1310. Epub 2016 Jun 30.

a Department of Psychology , Louisiana State University , Baton Rouge , LA , USA.

Introduction: For the majority of the autism spectrum disorder (ASD) population, symptoms begin within the first years of life and associated difficulties continue throughout the lifespan. Currently, the research literature focuses more heavily on problems in childhood. However, given that adulthood accounts for the majority of life, more focus should be placed on evidence-based, lifelong treatment and management strategies for ASD. Areas covered: This paper reviews the topic of lifelong ASD management, primarily emphasizing issues in adolescence and adulthood. Among the topics discussed are timing and methods of treatment across the lifespan, and specific intervention targets that emerge or are more relevant to this older cohort. Expert commentary: Several advances have been made in the treatment of adolescent and adult specific issues. However, research should continue to focus on these areas. Greater focus on coordination of care across disciplines and policy regarding ASD management over the lifespan is also required.
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http://dx.doi.org/10.1080/14737175.2016.1203255DOI Listing
November 2016

Comorbid Symptomology in Adults with Autism Spectrum Disorder and Intellectual Disability.

J Autism Dev Disord 2015 Dec;45(12):3961-70

Department of Psychology, Louisiana State University, Baton Rouge, LA, 70803, USA.

Evidence-based treatment must begin with the systematic and comprehensive identification of an individual's complete clinical picture. Therefore, screening individuals with intellectual disability (ID) for comorbid disorders is imperative. Because of the frequent overlap between autism spectrum disorder (ASD) and ID, the current study explored the effects of co-occurring ASD on the comorbid symptoms exhibited by adults with ID. The study included 307 adults with severe or profound ID separated into two groups: ASD+ID and ID only. The ASD+ID group exhibited significantly more symptomology on eight of the 12 subscales examined including anxiety, mania, schizophrenia, stereotypies/tics, self-injurious behavior, eating disorders, sexual disorders, and impulse control. Further, comparisons of specific symptom endorsements yielded distinct results.
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http://dx.doi.org/10.1007/s10803-015-2553-zDOI Listing
December 2015

Assessing aggression in persons with autism spectrum disorders: an overview.

Res Dev Disabil 2014 Dec 30;35(12):3269-75. Epub 2014 Aug 30.

Louisiana State University, USA. Electronic address:

Aggression is a commonly co-occurring problem with autism spectrum disorders (ASD). Comorbid aggression can be every bit as debilitating as core symptoms of ASD itself. As a result, careful identification of aggression, the context in which it occurs, and factors that maintain the behavior all have important implications for treatment. As a result, researchers have begun to develop methods and measures to assess aggression among persons with ASD. The purpose of this paper was to review measures that have been used to assess aggression among persons with ASD. We located 25 different assessment methods for both children and adults. The current status and future directions of this area of research are discussed.
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http://dx.doi.org/10.1016/j.ridd.2014.08.004DOI Listing
December 2014

An examination of the relationship between autism spectrum disorder, intellectual functioning, and comorbid symptoms in children.

Res Dev Disabil 2014 Jul 21;35(7):1766-72. Epub 2014 Mar 21.

Louisiana State University, USA.

There is a deficiency of research looking at how rates of comorbid psychopathology are effected by autism spectrum disorder (ASD) and intellectual functioning level. The present study aimed to extend the literature in this area by evaluating how ASD and IQ scores are related to ratings on a measure of comorbid symptoms. Twenty-three children with ASD and 87 children without ASD participated in this study. Rates of tantrum behavior, avoidant behavior, worry/depressed, repetitive behavior, under-eating, over-eating, and conduct behavior were examined utilizing the Autism Spectrum Disorders-Comorbidity for Children (ASD-CC). Correlational and multiple regression analyses were then conducted. ASD diagnosis significantly predicted rates of tantrum behavior, avoidant behavior, and repetitive behavior. Children with ASD tended to have higher rates of all three of these comorbid symptoms than children without ASD. Although not statistically significant, there was a negative correlation between IQ and rates of comorbid symptoms, such that children with higher IQ scores tended to have lower rates of comorbid symptoms. The implications of these findings on assessment and intervention are discussed.
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http://dx.doi.org/10.1016/j.ridd.2014.02.013DOI Listing
July 2014

Commonly studied comorbid psychopathologies among persons with autism spectrum disorder.

Res Dev Disabil 2014 May 12;35(5):952-62. Epub 2014 Mar 12.

Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, United States. Electronic address:

The study of comorbid psychopathology among persons with autism spectrum disorder (ASD) is picking up steam. The purpose of this paper was to review and describe important characteristics of existing studies. Among the current crop of papers, depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD) have been frequently evaluated. Groups studied have most frequently been children. Persons with ASD and normal intelligence quotient (IQ) scores have been studied more often than individuals with ASD and intellectual disability. Additional characteristics are discussed, and the implications of these data for future developments in the field are reviewed.
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http://dx.doi.org/10.1016/j.ridd.2014.02.012DOI Listing
May 2014

Autism severity as a predictor of inattention and impulsivity in toddlers.

Dev Neurorehabil 2015 19;18(5):285-9. Epub 2013 Jul 19.

a Department of Psychology , Louisiana State University , Baton Rouge , LA , USA.

Objective: Evaluate how severity of autism spectrum disorder (ASD) symptoms predicts attention-deficit/hyperactivity disorder (ADHD) symptoms in atypically developing toddlers.

Method: Parents/caregivers of 2300 atypically developing toddlers' ages 18-37 months were assessed about their children's behaviours using the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT) Part 1 and the inattention/impulsivity subscale of the BISCUIT-Part 2.

Results: ASD symptom severity was positively and significantly correlated with inattention/impulsivity, indicating that children with more severe symptoms of ASD tended to have higher scores on the measure of inattention/impulsivity, R(2) = 0.49, F (1, 2298) = 2234.72, p < 0.001. Additionally, ASD symptom severity significantly predicted inattention/impulsivity, β = 0.70, t (2298) = 47.27, p < 0.001.

Conclusions: ASD symptom severity predicts rates of ADHD symptoms in atypically developing toddlers. The implications of these findings are discussed in the context of other research.
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http://dx.doi.org/10.3109/17518423.2013.807884DOI Listing
May 2016

Comorbid psychopathology rates in children diagnosed with autism spectrum disorders according to the DSM-IV-TR and the proposed DSM-5.

Dev Neurorehabil 2015 19;18(4):218-23. Epub 2013 Jul 19.

Department of Psychology, Louisiana State University , Baton Rouge, LA , USA.

Objective: To investigate differences in comorbid psychopathology rates between individuals who meet criteria of Autism Spectrum Disorders (ASDs) according to DSM-5 or the DSM-IV-TR.

Methods: Comorbid psychopathology was measured using the Autism Spectrum Disorders- Comorbid for Children. 424 individuals between the ages of 2 and 18 years of age; including children who met criteria for an ASD according to the DSM-5, the DSM-IV-TR only, and a control group that did not meet either set of criteria.

Results: Of the ASD participants, 36% would no longer meet criteria according to proposed DSM-5. Comorbidity rates for the ASD groups were significantly different from the control group; however, ASD groups were not significantly different in terms of total comorbid psychopathology.

Conclusion: The results elucidate the need for further research regarding services and treatments for those individuals that will no longer meet criteria for an ASD but still have significant rates of comorbid psychopathology.
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http://dx.doi.org/10.3109/17518423.2013.790519DOI Listing
February 2016

A comparison of tantrum behavior profiles in children with ASD, ADHD and comorbid ASD and ADHD.

Res Dev Disabil 2013 Sep 11;34(9):2669-75. Epub 2013 Jun 11.

Clinical Psychology, Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, United States.

The present study was conducted to compare rates of tantrum behaviors in children with autism spectrum disorders (ASD) (n=255), attention-deficit/hyperactivity disorder (ADHD) (n=40) and children with comorbid ASD and ADHD (n=47). Parents/guardians of children aged 3-16 years were surveyed about their children's behaviors using the Autism Spectrum Disorders-Comorbidity for Children (ASD-C-C). Children with ADHD alone differed from children with ASD alone and children with comorbid ASD and ADHD on rates of tantrum behaviors. Examination of individual tantrum behavior items indicated that children with comorbid ASD and ADHD have a more similar symptom presentation to children with ASD than children with ADHD. This study adds to the literature on the presentation of common co-occurring behaviors of ASD when there is comorbid ADHD. The implications of these findings may aid in the assessment and treatment of tantrum behaviors in children with comorbid ASD and ADHD.
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http://dx.doi.org/10.1016/j.ridd.2013.04.022DOI Listing
September 2013

Rates of comorbid symptoms in children with ASD, ADHD, and comorbid ASD and ADHD.

Res Dev Disabil 2013 Aug 22;34(8):2369-78. Epub 2013 May 22.

Clinical Psychology, Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, United States.

The current diagnostic criteria do not allow co-diagnosis of autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). As a result, there has been little research on how these two disorders co-occur in the ASD population. The current study aimed to extend the literature in this area by examining comorbid rates in three different diagnostic groups (ASD, ADHD, and comorbid ASD+ADHD) using the Autism Spectrum Disorders-Comorbidity for Children (ASD-CC). Children with comorbid ASD and ADHD evinced higher rates of comorbid symptoms than children with ASD or ADHD alone. Additionally, children with comorbid ASD and ADHD endorsed more severe comorbid symptoms. Implications regarding these findings are discussed.
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http://dx.doi.org/10.1016/j.ridd.2013.04.021DOI Listing
August 2013

Current status of the Matson Evaluation of Drug Side Effects (MEDS).

Res Dev Disabil 2013 May 24;34(5):1849-53. Epub 2013 Mar 24.

Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA.

The Matson Evaluation of Drug Side Effects (MEDS) is currently the best established and most researched measure of drug side effects in the intellectual disability (ID) literature. Initial research was conducted on its psychometric properties such as reliability and validity. More recent research studies have used the measure to determine the interactive effects of severity of drug side effects on adaptive and social behaviors as well as symptoms of commonly medicated psychiatric conditions among persons with ID. Most recently the MEDS has been used to study potential risk factors of psychotropic drugs. The present study was written to review the current status of MEDS research in the broader context of psychotropic drug side effect research in general.
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http://dx.doi.org/10.1016/j.ridd.2013.02.030DOI Listing
May 2013

Comparing challenging behavior in children diagnosed with autism spectrum disorders according to the DSM-IV-TR and the proposed DSM-5.

Dev Neurorehabil 2013 Dec 11;16(6):375-81. Epub 2013 Mar 11.

Department of Psychology, Louisiana State University , Baton Rouge, LA , USA.

Objective: The aim of the current study is to investigate challenging behavior in children who may no longer meet criteria for an autism spectrum disorder (ASD) diagnosis according to the proposed fifth edition of the Diagnostic and Statistical Manual (DSM-5).

Method: Children and adolescents (n = 459) were separated into three groups including those who met criteria for ASD according to the DSM-5 criteria (n = 219); those who will no longer qualify for an ASD diagnosis according to the DSM-5 but met criteria according to the DSM-IV-TR (n = 109); and a control group (n = 131). Scores on the Autism Spectrum Disorders - Problem Behaviors for Children (ASD-PB-C) were compared among groups.

Results: The DSM-5 captured a slightly more impaired population in terms of problem behavior.

Conclusion: Implications regarding access to treatment for those no longer meeting criteria need to be taken into consideration in the coming months.
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http://dx.doi.org/10.3109/17518423.2012.760119DOI Listing
December 2013