Perspectives Of Adults Research Articles

DIABETES MELLITUS TIPO 1 E 2 NA INFÂNCIA E SUA RELAÇÃO COM A FAMÍLIA

Type 1 Diabetes Mellitus is a chronic disease characterized by the loss of the body's ability to produce insulin due to the destruction of beta cells in the pancreas. Type 2 occurs when the body does not use the insulin produced, and its main causes are related to excess weight, a sedentary lifestyle, high triglycerides, hypertension and inadequate eating habits. The first discoveries about it were made in 1872 in a papyrus and clinically in 1812. Over the years, research on Diabetes Mellitus has been boosted, which has triggered the search for more effective treatments. This study aims to evaluate the impacts of type 1 and 2 Diabetes Mellitus on both the child's life and the parents' lives, in the emotional, economic and religious spheres, as well as in daily life with family and society. This is a bibliographical research, which used secondary sources of information, such as books, scientific articles and medical journals, such as the Scientific Electronic Library Online (Scielo) and the Public Medical Literature Analysis and Retrieval System Online (PubMed). The research aimed to identify the evidence available in these literatures that address, from the perspective of children and adults, the relevant factors for the elaboration of proposals for appropriate instructions for type 1 and type 2 Diabetes Mellitus. Knowledge of the epidemiological situation of type 1 and type 2 Diabetes Mellitus over the years provides support for directing resources to risk areas and for new strategies for preventing and controlling the disease in children, adolescents and adults.

Co-Designing a Conversational Agent With Older Adults With Chronic Obstructive Pulmonary Disease Who Age in Place: Qualitative Study.

As a reaction to the global demographic increase in older adults (aged 60+ years), policy makers call for initiatives to enable healthy aging. This includes a focus on person-centered care and access to long-term care for older adults, such as developing different services and digital health technologies. This can enable patients to engage in their health and reduce the burden on the health care systems and health care professionals. The European Union project Smart Inclusive Living Environments (SMILE) focuses on well-being and aging in place using new digital health technologies. The novelty of the SMILE project is the use of a cocreational approach focused on the needs and preferences of older adults with chronic obstructive pulmonary disease (COPD) in technology development, to enhance access, adaptation, and usability and to reduce stigma. The study aimed to describe the perspective, needs, and preferences of older adults living with COPD in the context of the design and development of a conversational agent. This study carried out a data-driven thematic analysis of interview data from 11 cocreation workshops with 33 older adults living with COPD. The three particular features that the workshop participants wanted to implement in a new technology were (1) a "my health" function, to use technology to manage and learn more about their condition; (2) a "daily activities" function, including an overview and information about social and physical activities in their local area; and (3) a "sleep" function, to manage circadian rhythm and enhance sleep quality, for example, through online video guides. In total, 2 overarching themes were identified for the 3 functions: measurements, which were actively discussed and received mixed interest among the participants, and health literacy, due to an overall interest in learning more about their condition in relation to everyday life. The future design of digital health technology must embrace the complexities of the everyday life of an older adult living with COPD and cater to their needs and preferences. Measurements should be optional and personalized, and digital solutions should be used as a supplement to health care professionals, not as substitute.

Adult stakeholders' perspectives on supporting or undermining the mental health of sexual and gender minoritised adolescents.

To explore adult stakeholders' perspectives on what supports or undermines the mental health of sexual and gender minoritised adolescents (SGMA) in everyday life in order to better understand how to foster supportive psychosocial environments for SGMA. Descriptive qualitative study design, using framework analysis. Semi-structured interviews were conducted remotely with 16 UK-based adult stakeholders which included parents of SGMA, health and social care professionals, community-based professionals, and professionals who commission services related to adolescent health and well-being. Nine themes were identified that represented barriers and enablers of fostering psychosocial environments that are supportive of SGMA mental health. Example barrier themes include SGMA 'facing chronic and acute safety threats and stress', 'psychological responses to social connection losses and navigating alienation', 'digital exposure and online risk and vulnerability' and 'conflicting messages, resulting divisions and adult distancing'. Example enablers include 'exploring, owning, and changing (personal) identities', 'advocating alongside adolescents whilst containing oneself as the adult in the situation' and 'personally fostering adolescents' psychological safety and inclusion'. Adult stakeholders report that SGMA are often exposed to environments hostile to key aspects of their identity which then by extension undermines their mental health. These experiences can threaten their sense of safety and evolving identity. Practitioners in particular should be aware of the stressors relating to SGMA identity and minoritisation experiences in order to develop the psychological safety and sense of inclusion needed for SGMA to trust in the relationship and the support offered.

Barriers and Facilitators to the Applicability of Adult Daycare Centers in Saudi Arabia: A Qualitative Study.

Adult daycare centers (ADCs) enable older adults to socialize and enjoy planned group activities while receiving healthcare services. These centers also assist caregivers by empowering them to remain in the workforce. This study aims to explore the challenges in establishing ADCs in Saudi Arabia (SA) from the perspectives of healthcare professionals, healthcare policymakers, older adults, and caregivers. Additionally, this study's objective is to identify the barriers, facilitators, and applicability of ADCs in SA. A qualitative study was conducted using semi-structured individual interviews. Inductive and deductive thematic analyses were employed to identify common themes regarding the barriers and facilitators to the applicability of ADCs in SA. Five researchers independently examined the transcripts using inductive analysis. Deductive analysis mapped the themes to Campinha-Bacote's cultural competence model. Data were collected from 46 participants, including caregivers, older adults, healthcare professionals, and healthcare policymakers. The findings highlight that the main facilitators to establishing ADCs in SA are the expected positive impact on the psychological and physical well-being of older adults and their caregivers. Conversely, cost and transportation, in addition to cultural considerations are possible barriers. This study identified the perceived benefits of ADCs for older adults and caregivers from a Saudi societal perspective. Thematic analysis showed that ADC's applicability in SA is possible, with some modifications to fit within the Saudi context. Additional efforts are necessary to promote the concepts and services that ADCs provide for older adults and to encourage support for these centers by non-profit organizations and the government.

Perspectives of Healthcare Professionals and People with a Spinal Cord Injury on Resistance Exercise Intensity in Japan, Indonesia, Korea and Thailand

(1) Background: This study aims to investigate differences in the perspectives of healthcare professionals (HCPs) and adults with spinal cord injury (SCI) on resistance exercise intensity in Asian countries in association with knowledge translation (KT). Also, it verifies the appropriateness of the conventional indicators for resistance exercise intensity in an Asian context. (2) Methods: 121 certified HCPs and 107 adults with SCI participated in a survey conducted in Indonesian, Japanese, Korean and Thai languages. The survey asked what principles are important for prescribing resistance exercise, and if ‘moderate’ and ‘vigorous’ were appropriate terms for indicating an intensity level. Perspective differences were examined between both groups and, further, between countries from a psychosocial perspective. (3) Results: Of the HCPs, 92% perceived that resistance exercise intensity was far more important than frequency, time or type of exercise while frequency (61%) followed by intensity (58%) was perceived as important by respondents with SCI. Only Japanese respondents with SCI agreed with the HCPs’ perception of intensity. Both HCPs and respondents with SCI showed unfavorable responses to the usage of ‘moderate’ and ‘vigorous’ for describing resistance exercise intensity, especially Japanese HCPs and respondents with SCI from Indonesia. (4) Conclusions: Our findings suggest that non-HCPs must improve their perceptions of exercise intensity. Our findings also suggest the need for more explicit and user-friendly terms or expressions indicating the level of intensity in a local (Asian) context.

Evaluation of "Age-Friendly City" Indicators in Golestan Province From the Perspective of the Older Adult Population

Objectives: To evaluate age-friendly city indicators from the perspective of the older adults in Golestan province in 2023. Design: A descriptive-analytical cross-sectional study. Setting(s): Golestan province, Iran. Participants: Individuals aged 60 years and above. Outcome measures: A sample of 310 participants was selected using proportional stratified sampling. Data were collected with a validated age-friendly city questionnaire. Results: The mean age of the participants in this study was 70.34±7.73 years (ranging from 60 to 99), with 64.5% being male. Among the three examined components, the component of respect and social security had the highest average among the older adults (4.65±17.72), followed by social participation (4.79±16.30) and civic engagement and employment (4.052±12.20). Agefriendly city indicators demonstrated statistically significant differences in variables such as city of residence (P=0.02), support source (P=0.009), income level (P=0.001), and marital status (P=0.05). Conclusions: None of the examined age-friendly city components in Golestan province met the necessary standards. Recommendations include enhancing efforts by service organizations to improve conditions for older adults.

Barriers and facilitators to the uptake of electronic collection and use of patient-reported measures in routine care of older adults: a systematic review with qualitative evidence synthesis.

The aims of this systematic review were to (1) synthesize the available qualitative evidence on the barriers and facilitators influencing implementation of the electronic collection and use of patient-reported measures (PRMs) in older adults' care from various stakeholder perspectives and (2) map these factors to the digital technology implementation framework Non-adoption, Abandonment, challenges to the Scale-up, Spread, Sustainability (NASSS) and behavior change framework Capability, Opportunity, Motivation, Behaviour (COM-B). A search of MEDLINE, CINAHL Plus, and Web of Science databases from 1 January 2001 to 27 October 2021 was conducted and included English language qualitative studies exploring stakeholder perspectives on the electronic collection and use of PRMs in older adults' care. Two authors independently screened studies, conducted data extraction, quality appraisal using the Critical Appraisal Skills Programme (CASP), data coding, assessed confidence in review findings using Grading of Recommendations Assessment, Development, and Evaluation Confidence in the Evidence from Reviews of Qualitative Research (GRADE CERQual), and mapped the findings to NASSS and COM-B. An inductive approach was used to synthesize findings describing the stakeholder perspectives of barriers and facilitators. Twenty-two studies were included from the 3368 records identified. Studies explored older adult, caregiver, healthcare professional, and administrative staff perspectives. Twenty nine of 34 review findings (85%) were graded as having high or moderate confidence. Key factors salient to older adults related to clinical conditions and socio-cultural factors, digital literacy, access to digital technology, and user interface. Factors salient to healthcare professionals related to resource availability to collect and use PRMs, and value of PRMs collection and use. Future efforts to implement electronic collection and use of PRMs in older adults' care should consider addressing the barriers, facilitators, and key theoretical domains identified in this review. Older adults are more likely to adopt electronic completion of PRMs when barriers associated with digital technology access, digital literacy, and user interface are addressed. Future research should explore the perspectives of other stakeholders, including those of organizational leaders, digital technology developers and implementation specialists, in various healthcare settings and explore factors influencing implementation of PREMs. CRD42022295894.

유아교사의 아동인권에 대한 메타포 분석

The purpose of this study is to analyze the metaphors of children's rights of early childhood teachers and examine their awareness and values of children's rights. To this end, from the first week of March 2024 to the fourth week of April 2024, we collected and analyzed metaphors of children's rights through an open-ended questionnaire targeting 190 early childhood teachers living in G City and G Province for approximately two months. The results of the study are as follows. First, from the adult's perspective, children's rights were expressed as ‘children's lives themselves’ and ‘our collective efforts’. Second, from the perspective of viewing children, they were expressed as ‘children as rights holders’ and ‘children as socially vulnerable’. Finally, from the teacher's perspective, they were expressed as ‘teachers as duty-bearers’ and ‘teachers who must make social efforts’, and were classified into three categories in total. Through this study, we examined early childhood teachers' awareness of children's rights and suggested implications for the direction of desirable implementation of children's rights.

"Treat people with human dignity": the perspective of older adults on the quality of geriatric rehabilitation.

The aim of this study was to gain insight into the perspectives of older adults on the quality of geriatric rehabilitation (GR) during the trajectory of GR from admission until six weeks after discharge. We conducted a longitudinal qualitative study. Participants were interviewed three times: at the start of rehabilitation, at discharge, and six weeks after discharge. The data were analysed using a thematic analysis. In total, 50 interviews were conducted, with 18 participants being interviewed multiple times. The following themes emerged: 1. A bond of trust with health care professionals (HCPs), 2. Being prepared and informed at all stages of GR, 3. Participants emphasise physical and occupational therapy rather than other aspects of care as comprising GR 4. Changing needs regarding (the extent of) involvement in decision-making, 5. Contact with family and peers. For older adults, preparation for and good organisation of rehabilitation and social interaction with HCPs and other older adults were found to be important for the perceived quality of GR. Social interaction is influenced by how HCPs engage with older adults in all the phases of the rehabilitation process. Older adults have varying preferences about involvement in decision-making during GR. These perspectives should be acknowledged and acted upon in clinical practice to further improve the quality of care in GR.

Decisional needs for older adults, home health care nurses and dental hygienists during team-based oral health assessments in ordinary home settings – a qualitative study

BackgroundParticipation by all actors involved in health planning is a prerequisite for person-centred care and healthy ageing. Understanding the multiple knowledge needs and the values that shape oral health assessments in home settings is important both to enable participation in oral health planning and to contribute to healthy ageing.ObjectiveThe aim of this study was to investigate decisional needs during oral health assessments in ordinary home settings from the perspectives of older adults, home health care nurses and dental hygienists.MethodsData was collected in ordinary home settings through 24 team-based oral assessments and 39 brief, semi-structured interviews including older adults (n = 24), home health care nurses (n = 8) and dental hygienists (n = 7). Data was analysed using content analysis with a deductive approach. The analysis was guided by the Ottawa Decision Support Guide.ResultsThe analysis revealed that all participants considered participation in decision-making important but until now, older adults might not have participated in making decisions regarding oral health issues. The older adults considered participation important because the decisions had a strong impact on their lives, affecting their health. The professionals considered decision-making important for knowing what step to take next and to be able to follow up and evaluate previous goals and treatments. Organizational and personal barriers for shared decision-making among home health care nurses and dental hygienists were identified. Of the 24 older adults, 20 had different oral health conditions that objectively indicated the need for treatment. An initial important decision concerned whether the older adult wanted to make an appointment for dental care, and if so, how. Another decisional conflict concerned whether and how assisted oral care should be carried out.ConclusionIt is important for key participants in ordinary home settings to participate in interprofessional teams in home health care. To further anchor this in theory, conceptual models for professionals from different care organizations (municipal care, dental care) need to be developed that also involve older adults as participants. Future research could bridge theory and practice by including theories of learning while exploring interorganizational oral health planning in home settings.

Summary of: A systematic review and thematic synthesis of the challenges associated with dental appointments, from the perspective of autistic adults

Summary of: A systematic review and thematic synthesis of the challenges associated with dental appointments, from the perspective of autistic adults

Physical activity from the perspective of older adults: a convergent mixed-method study

BackgroundOlder adults are insufficiently physically active, despite its importance for healthy aging. To develop appropriate physical activity interventions, it is necessary to understand their physical activity. This study applies a theoretical perspective, the COM-B model, and a mixed-method design to examine what influences older adults’ physical activity levels with three questions: (1) What individual and external factors predict older adults’ physical activity levels? (2) What do older adults perceive as influencing their levels of physical activity? (3) To what extent do the quantitative results on older adults’ physical activity levels agree and disagree with the qualitative findings on older adults’ physical activity levels?MethodsA convergent mixed-method design was used with questionnaire (n = 334) and interview (n = 14) data from adults 65 years and older. Regression analyses were used for quantitative measurements: physical activity, age, subjective socioeconomic status, health status, capability, opportunity, motivation, and depression. Content analysis was applied to the qualitative data. The two forms of data were then integrated to provide greater insights than would be obtained by either dataset separately.ResultsThe regression analyses showed that previous physical activity, current motivation, health status, and age significantly predicted older adults’ physical activity levels. The content analysis revealed that participants addressed all subcomponents of the COM-B model, indicating its pertinence in understanding how older adults discuss their current physical activity levels. The integrated findings showed convergent and divergent results. Overall results indicated that previous physical activity engagement, present motivation, capability, and opportunity influenced older adults’ physical activity levels.ConclusionsThis study is the first to use this mixed-methods design to examine factors influencing physical activity levels among older adults living in rental apartments with community hosts. The integrated result reveals convergence for findings on motivation and physical capability but divergence on psychological capability, opportunity, and previous physical activity. The findings underscore a complex interplay of factors influencing older adults’ physical activity levels and indicate relevance for the COM-B model. The results can guide future research on theoretically informed interventions to promote physical activity and healthy aging. Future research should clarify the role of opportunity for older adults’ physical activity.

Recommendations to Address Barriers to Patient Portal Use Among Persons With Diabetes Seeking Care at Community Health Centers: Interview Study With Patients and Health Care Providers.

Community health centers (CHCs) are safety-net health care facilities in the United States that provide care for a substantial number of low-income, non-English speaking adults with type 2 diabetes (T2D). Whereas patient portals have been shown to be associated with significant improvements in diabetes self-management and outcomes, they remain underused in CHCs. In addition, little is known about the specific barriers to and facilitators of patient portal use in CHCs and strategies to address the barriers. The objectives of this qualitative study were to explore the barriers to and facilitators of the use of patient portals for managing diabetes in 2 CHCs from the perspective of adults with T2D and clinicians (community health workers, nurses, nurse practitioners, and physicians) and to make recommendations on strategies to enhance use. A qualitative description design was used. A total of 21 participants (n=13, 62% clinicians and n=8, 38% adults with T2D) were purposively and conveniently selected from 2 CHCs. Adults with T2D were included if they were an established patient of one of the partner CHCs, aged ≥18 years, diagnosed with T2D ≥6 months, and able to read English or Spanish. Clinicians at our partner CHCs who provided care or services for adults with T2D were eligible for this study. Semistructured interviews were conducted in either Spanish or English based on participant preference. Interviews were audio-recorded and transcribed. Spanish interviews were translated into English by a bilingual research assistant. Data were collected between October 5, 2022, and March 16, 2023. Data were analyzed using a rapid content analysis method. Standards of rigor were implemented. Themes generated from interviews included perceived usefulness and challenges of the patient portal, strategies to improve patient portal use, and challenges in diabetes self-management. Participants were enthusiastic about the potential of the portal to improve access to health information and patient-clinician communication. However, challenges of health and technology literacy, maintaining engagement, and clinician burden were identified. Standardized implementation strategies were recommended to raise awareness of patient portal benefits, provide simplified training and technology support, change clinic workflow to triage messages, customize portal notification messages, minimize clinician burden, and enhance the ease with which blood glucose data can be uploaded into the portal. Adults with T2D and clinicians at CHCs continue to report pervasive challenges to patient portal use in CHCs. Providing training and technical support on patient portal use for patients with low health literacy at CHCs is a critical next step. Implementing standardized patient portal strategies to address the unique needs of patients receiving care at CHCs also has the potential to improve health equity and health outcomes associated with patient portal use.

Narrative Inquiry Describing Young Adult Perspectives About Leaving Residential Treatment as a Child

ABSTRACT Empirical research exploring treatment outcomes among children in residential treatment centers (RTCs) is rare. Consequentially, there is an increasing demand for more studies examining such outcomes, particularly as they pertain to an individual’s experience leaving an RTC. This transitional period is believed to be a salient component impacting mental health treatment outcomes. Yet, little is known about how this residential treatment component is experienced and whether it impacts individuals long-term. This narrative qualitative study aimed to understand the experience of young adults who transitioned out of an RTC as a child. Participants recounted their experiences before, during, and after this transition. Six participants who resided in an RTC as a child for at least six consecutive months recounted their life experiences, producing 26 hours of interview data. Data were transcribed, coded, and written in narrative and thematic form. Our analysis produced three themes: learned and used effective coping skills, developed impactful relationships, and difficult adjustment post-discharge.

Rethinking Lifetime Abuse in Old Age.

Research on abuse is often piecemeal and focused on specific forms, populations, and social situations. As a result, these studies tend to ignore the web of abuse resulting from the interactive effects of various forms of abuse over the life course, together referred to as "lifetime abuse." An examination of abuse from the point of view of older adults is likely to provide a lifetime perspective based on linking child abuse to elder abuse over the life course and an assessment of its consequences. Despite the growing awareness and resulting body of knowledge regarding this phenomenon, proposed theoretical formulations about it remain limited. The present article aimed to conceptualize the multifaceted phenomenon of lifetime abuse and to gain a deeper perspective of the topic by understanding its dimensions, meanings, and experiences in older age, based on a critical review of empirical studies. A model is suggested, which can be useful for future exploration and understanding of lifetime abuse. Based on a critical review of previous studies, we suggest a theoretical framework of lifetime abuse from the perspective of older adults, identifying three key domains: (a) perception of time and life review in old age; (b) cumulative and interactive abusive life events; and (c) resilience versus vulnerability over the life course. We propose a heuristic model to explore and understand lifetime abuse. We believe our proposed model is open to reflection and elaboration and is intended to raise questions that could enhance the need for our understanding of lifetime abuse in old age.

Young Adult Cancer Patients (AYA): Preferences for Outpatient Psychosocial Care and Gender-Specific Differences - Results from the AYA-LE study

To investigate the importance of individual topics in outpatient care services and the preferences for their design from the perspective of young adults with cancer (AYA="adolescents and young adults") in Germany. A total of 514 AYAs aged 18-39 years were surveyed twice over a 12-month period (t1=immediately after acute treatment, t2=12 months post-treatment) regarding the importance and satisfaction with topics such as anxiety, the impact of the illness on partnerships/family and social environment, future perspectives, personal coping strategies, sexuality, and desire for children/fertility, as well as the types of care services. The subjective importance and satisfaction with the care topics and services were analyzed using variance and moderator analyses. The most important topics for care services were future career prospects (M=3.22, SD=1.56), social impact (M=3.19, SD=1.54), and personal coping strategies (M=3.52, SD=1.46). The greatest dissatisfaction was noted in the areas of sexuality (M=2.01, SD=1.59) and desire for children/fertility (M=2.08, SD=1.72). At time t2, relaxation techniques (M=3.46, SD=1.36) and psychological counseling (M=3.43, SD=1.46) were the most desired care services. Female AYAs rated psychological counseling (F[1.199)=9.21, p=0.003), social counseling (F[1.221]=6.60, p=0.011), creative therapy options (F[1.219]=21.74, p<0.001), support groups (F[1.215]=4.29, p=0.040), patient education (F[1.210]=6.96, p=0.009), and relaxation techniques (F[1.194]=23.68, p<0.001) significantly more important than male AYAs. The study highlighted several areas of dissatisfaction with the current outpatient care services for AYAs. The results demonstrate the need to incorporate cross-sex and gender-specific care preferences of AYAs to improve outpatient psychosocial care. A specific set of AYA-care services should be designed and implemented to address the aforementioned psychosocial topics, which include sexuality and the desire for children/fertility. It is also crucial for outpatient practice to raise awareness among the involved professional groups. Further research is required to gain a deeper understanding of sex differences.

“I need as much support as I can get”: A qualitative study of young adult perspectives on family involvement in treatment for opioid use disorder

BackgroundOpioid use disorder (OUD) among young adults (YAs) continues to persist as a national health crisis. Best practice recommendations for YA OUD treatment highlight the importance of medication for OUD (MOUD) and family involvement across the treatment services continuum for better treatment retention and outcomes. Yet, concerned significant others (CSOs) such as family members, romantic partners, and family-of-choice members are not routinely involved in OUD and MOUD treatment for YAs. MethodWe used convenience sampling to recruit 25 YAs (ages 21 to 36) in treatment for OUD from two urban treatment centers. We discussed with YAs the identities of their CSOs and the dynamics of those relationships, their perspectives on CSO involvement in their OUD treatment, and the beliefs and attitudes they hold about family involvement in treatment and recovery. Thematic content analysis was deductive-dominant based on a semi-structured qualitative interview guide. Group consensus coding was followed by matrix analysis. ResultsWe identified five main themes: (1) YA and CSO relationships were supportive, evolving, and complex. (2) CSO support motivated treatment engagement and participation. (3) Only a small proportion of CSOs participated in treatment activities despite actively supporting treatment in other ways. (4) YAs experienced their CSOs as supportive of their treatment and recovery goals, including MOUD. (5) YAs believed family involvement is essential to treatment and many were unsatisfied with current family involvement in their care. ConclusionsIn this qualitative study of OUD treatment experiences among YAs, we learned that many YAs have CSOs who are invested in their treatment and recovery and yet are not routinely involved in treatment. Moreover, YAs often expressed family involvement is essential to OUD treatment, and many expressed a desire for greater family involvement in their own treatment. Clinical recommendations for relationship-oriented treatment are presented.

Parent and Young Adult Perspectives About the Transition to College During the COVID-19 Pandemic.

The purpose of this study was to describe the influence of COVID-19 on parents and their young adults with type 1 diabetes as they navigated the college environment during the COVID-19 pandemic. A sample of 9 college students with type 1 diabetes and their parents were recruited to participate in interviews via purposive sampling methodology. A descriptive, qualitative study was conducted using semi-structured questions via recorded video conferencing interviews. Three themes related to navigating type 1 diabetes at college during the pandemic emerged: (1) isolation and mental health: COVID-19-related isolation and loneliness; (2) risk and exposure to COVID-19: balancing risk of COVID-19 with type 1 diabetes; and (3) management of type 1 diabetes on campus during the pandemic: academics, university policies, and their impact on type 1 diabetes. Students with type 1 diabetes and their parents had to navigate a complex set of concerns that extended beyond the usual challenges of diabetes management during the COVID-19 pandemic. Providers must provide additional support and incorporate education about type 1 diabetes management strategies to families affected by large-scale health crises.

Interests, Plans, and Hopes for Life After High School From Autistic Young Adults’ Perspectives

Obtaining the perspectives of autistic young adults is critical for planning educational and service delivery systems focused on the preparation for a high life quality after high school. The perspective and voice of autistic young adults who participated in the Center on Secondary Education for Students with Autism (CSESA) multi-site follow-up study conducted across three states (North Carolina, Wisconsin, and California) are described. Participants who exited high school or were enrolled in a district transition program responded to short-answer items on a Young Adult Questionnaire and Interview ( n = 148) and completed the Adolescent and Young Adult Activity Card Sort (Berg, 2015; n = 150) to address research questions about their current interests, future plans, and perceived barriers to fulfilling future plans using descriptive statistics and coding of interview responses. The young adults report current engagement in leisure activities, and 79% seek a job change and the opportunity to date and engage in a long-term relationship.

Best Practices for Supporting Social–Emotional Development in Children With Developmental Language Disorder and Attention-Deficit/Hyperactivity Disorder

Purpose: Children with developmental language disorder (DLD) and/or attention-deficit/hyperactivity disorder (ADHD) are at an elevated risk of social–emotional difficulties, including low self-esteem and anxiety, related to school achievement and peer interactions. This clinical focus article provides best practice guidelines, shaped by a neurodiversity-affirming lens, to support children's social–emotional development. Method: The guidelines were developed through interprofessional discussions among the authors, which included three communication specialists and two mental health specialists, and supported by review of the scholarly literature on neurodiversity, DLD, and ADHD, with a focus on first-person perspectives of children and adults with these conditions and their parents and teachers. Results: The practice guidelines include recommendations for the interprofessional assessment of DLD and/or ADHD and suggestions for neurodiversity-affirming supports to promote acceptance of students with DLD and/or ADHD by teachers and peers. Intervention recommendations for social communication skills, self-regulation supports, and self-advocacy are described. A hypothetical case study is provided to illustrate implementation of the recommended practices. Conclusions: First-person and family perspectives studies provide compelling evidence that having DLD and/or ADHD, coupled with the negative reactions of others to children's differences related to these conditions, have adverse effects on children's social–emotional development. Speech-language pathologists and their interprofessional team members have an important role to play in preventing these effects by providing social–emotional supports for children with DLD and/or ADHD.