Heidi Feldman, MD, PhD

Family navigation (FN) has emerged as a promising intervention for reducing barriers and addressing social and economic inequities in autism service delivery. Little is known regarding the implementation and effectiveness of FN for children with autism. The aims of this scoping review are to: (1) summarize the breadth, quantity, and characteristics of the existing literature on FN for children diagnosed with autism; (2) describe the models and outcomes of FN for this population; and (3) identify knowledge gaps and provide directions for future research. Authors used Arksey and O'Malley's methodological framework for scoping reviews. Searches were conducted in PubMed, CINAHL, Embase, Social Services Abstracts, and Web of Science, resulting in identification of 308 papers. Two independent raters completed title/abstract and full-text screenings. Data was extracted using a researcher-developed tool. Results synthesis involved content and construct analysis and descriptive numerical summaries. 17 publications met inclusion criteria. Among these, seven studies evaluated FN models delivered by professional or peer navigators. Three studies investigated FN tools. The remaining seven papers included five qualitative and two mixed methods studies that provided valuable insights on improving FN programs. Overall, studies on FN models reported positive impacts on family activation and well-being, knowledge, and service access and utilization. None addressed improvements in child developmental status or behavioral profiles. FN is a promising intervention for improving family outcomes and increasing service access and utilization. Further research is needed to establish best practices, identify child- and family-centered outcome metrics, and promote scalability and sustainability.

View details for DOI 10.1007/s10803-025-06798-9

View details for PubMedID 40100561

View details for PubMedCentralID 10637767

PURPOSE: To determine if reading development between ages 6 and 8 years related to changes in fractional anisotropy (FA) in the optic radiations (OR), and if these associations were similar in children born full term (FT) and preterm (PT) and in language tracts.METHODS: FT (n = 34) and PT (n = 34) children completed the Word Identification subtest of the Woodcock Reading Mastery Test at 6, 7, and 8 years. Diffusion MRI (96-directions, b=2500 sec/mm2) was acquired at 6 and 8 years. Probabilistic tractography identified bilateral OR and three left-hemisphere language tracts: inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus (SLF), and arcuate fasciculus (AF). Linear mixed models determined if FA changes in these tracts were associated with reading growth.RESULTS: Rates of reading growth were similar in both groups. For the OR, FA change from 6 to 8 years was negatively associated with reading growth in both groups. A similar pattern was observed in the left ILF but not in the SLF or AF.CONCLUSION: Individual differences in reading development were associated with FA change of the OR and left ILF in FT and PT children. Negative associations implicate increasing axonal diameter and/or complexity in fiber structure as drivers of faster reading development.

View details for DOI 10.1016/j.dcn.2025.101520

View details for PubMedID 39892155

To assess the accuracy of a large language model (LLM) in measuring clinician adherence to practice guidelines for monitoring side effects after prescribing medications for children with attention-deficit/hyperactivity disorder (ADHD).Retrospective population-based cohort study of electronic health records. Cohort included children aged 6 to 11 years with ADHD diagnosis and 2 or more ADHD medication encounters (stimulants or nonstimulants prescribed) between 2015 and 2022 in a community-based primary health care network (n = 1201). To identify documentation of side effects inquiry, we trained, tested, and deployed an open-source LLM (LLaMA) on all clinical notes from ADHD-related encounters (ADHD diagnosis or ADHD medication prescription), including in-clinic/telehealth and telephone encounters (n = 15 628 notes). Model performance was assessed using holdout and deployment test sets, compared with manual medical record review.The LLaMA model accurately classified notes that contained side effects inquiry (sensitivity = 87.2, specificity = 86.3, area under curve = 0.93 on holdout test set). Analyses revealed no model bias in relation to patient sex or insurance. Mean age (SD) at first prescription was 8.8 (1.6) years; characteristics were mostly similar across patients with and without documented side effects inquiry. Rates of documented side effects inquiry were lower for telephone encounters than for in-clinic/telehealth encounters (51.9% vs 73.0%, P < .001). Side effects inquiry was documented in 61.4% of encounters after stimulant prescriptions and 48.5% of encounters after nonstimulant prescriptions (P = .041).Deploying an LLM on a variable set of clinical notes, including telephone notes, offered scalable measurement of quality of care and uncovered opportunities to improve psychopharmacological medication management in primary care.

View details for DOI 10.1542/peds.2024-067223

View details for PubMedID 39701141

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View details for Web of Science ID 001430200800586

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View details for Web of Science ID 001430200800583