Browsing by Author "McMorris, Carly A."

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    Anxiety in Children and Youth With Autism Spectrum Disorder: Perceptions of Implementing the Facing Your Fears Program in Hospital and Community Organizations
    (2019-04-16) Berlanda, Laura; McMorris, Carly A.; Makarenko, Erica; Schwartz, Kelly Dean
    The Facing Your Fears (FYF) program is a family-centred intervention designed to teach children and youth with ASD strategies to reduce co-occurring symptoms of anxiety. The present study explored the process of implementing the FYF program through the perceptions of facilitators and managers in either a hospital setting or community organization, in addition to determining the treatment outcomes for participants who completed FYF. Sixteen facilitators and managers were interviewed regarding their perceptions of the compatibility, complexity, relative advantages, barriers, challenges, and adaptations that arose during implementation. Overall, facilitators and managers from both organizations reported that FYF had good compatibility with their organization, implementation of FYF was not too complex, and members of each organization reported advantages that were related to their setting. Facilitators and managers reported barriers and challenges that were organized into four theme-categories: system-level, intervention delivery, logistics, and individual and family. Adaptation themes directly reflected the barriers and challenges that each organization encountered when implementing FYF, as modifications were needed to be made to the intervention as well as the organization structure to overcome the difficulties of implementing an evidence-based intervention into clinical practice. Despite these modifications, both parent and child reported symptoms of anxiety, in addition to social responsiveness changed post intervention. Factors that may have impacted changes in anxiety symptoms, such as increased understanding or awareness of anxiety, are discussed in more detail. These findings provide foundational knowledge to the understanding of the strengths and challenges of implementing FYF in clinical practice across different settings. Additionally, knowledge gained from the current project may be beneficial and useful for future facilitators and managers to consider when preparing to implement and implementing FYF within their organization.
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    Co-constructing the Past: Examining Mother- and Father-Child Narratives About Past Events Involving Pain versus Sadness
    (2019-08-26) Pavlova, Maria; Noel, Melanie; Graham, Susan A.; Madigan, Sheri L.; McMorris, Carly A.
    Background. Parent-child reminiscing about past events creates an influential sociolinguistic context within which children’s development occurs. Parents differ dramatically in their reminiscing styles, whereas some parents are highly elaborative (i.e., they use open-ended detailed questions) and focus on talking about emotions, other parents are repetitive and emphasize factual information. Elaborative reminiscing has been linked to more optimal developmental outcomes. No studies have examined how parent-children reminiscing about past pain compares to other stressful experiences (i.e., sadness, fear), and how parent-children reminiscing about past pain might be linked to children’s socio-emotional skills. This study was the first to examine the association between parent-child reminiscing about past pain and children’s prosocial acts to pain-related distress in others as well as overall children’s socio-emotional functioning. Methods. One hundred and sixteen 4-year old children (54% girls) and their parents (49% mothers) completed a structured narrative elicitation task wherein they reminisced about a unique past event involving pain, fear, and sadness. Children then witnessed a confederate pretending to be in pain (i.e., hurt fingers and a knee). Children’s prosocial responses and parent-child narratives about past pain were coded using established coding schemes based on the developmental psychology literature. Results. Parent-children narratives about pain were characterized by less emotion-laden and more coping and pain-related words as compared to sadness or fearful narratives. Parents, who used open-ended questions, provided new information, and talked about emotions and coping when talking about past events involving pain, had children who exhibited more prosocial acts and concern in response to other’s pain and had higher parent-reported levels of empathy. Discussion. Parent-children reminiscing about past pain differs from reminiscing about other types of distressing events (e.g., involving sadness or fear) and is linked to children’s socio-emotional skills. This highlights a possibility of differential socialization of pain. Parent-child reminiscing is amenable to intervention and offers a promising avenue for pediatric pain management interventions.
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    Cumulative Risk and Mental Health Outcomes in Children Prenatally Exposed to Alcohol
    (2019-08-20) Ritter, Chantel M.; McMorris, Carly A.; Badry, Dorothy Eleanor; Exner-Cortens, Deinera
    Fetal alcohol spectrum disorder (FASD) is caused by exposure to alcohol in utero and is the leading cause of birth defects and developmental disabilities. The timing, frequency, and dosage of alcohol consumed during the prenatal period contribute to the heterogeneous presentation of FASD, which includes physical, adaptive, behavioural, and social-emotional difficulties. Difficulties are often solely attributed to the effects of alcohol, yet alcohol is rarely the only explanatory factor for outcomes. Specifically, prenatal alcohol exposure (PAE) often co-occurs with other substances, as well as other environmental factors such as lack of prenatal care or poverty/malnutrition. Children and youth with FASD often experience adverse experiences postnatally, such as abuse or neglect. These factors may cumulatively interact to alter individual trajectories of children with PAE. The purpose of this study is to examine the relationship between cumulative risk factors (both prenatally and postnatally) on mental health outcomes of children exposed to alcohol prenatally. Additionally, the study aims to investigate what/if clinical neurocognitive factors further explain the variance associated with mental health outcomes, given the high prevalence of neurocognitive difficulties in this population. Results demonstrate that although PAE frequently co-occurs with a variety of other prenatal factors, in our sample, PAE was the most significant predictor of mental health symptoms, as measured by the Kiddie Schedule for Affective Disorders and Schizophrenia – Present and Lifetime Version (KSADS-PL). Our findings also show that postnatal threat or deprivation occurring after two years of age significantly predicted executive dysfunction. A hierarchical multiple regression was run to determine if the addition of postnatal experiences and EF to PAE significantly predicted symptom count. It was found that postnatal risks and executive functioning abilities better explained total mental health symptom count than PAE alone. The research and practice implications of the present study findings are discussed, in addition to strengths, limitations, and for future research directions.
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    Development and validation of the Cannabis Exposure in Pregnancy Tool (CEPT): a mixed methods study
    (2024-04-16) Chaput, Kathleen H.; McMorris, Carly A.; Metcalfe, Amy; Ringham, Catherine; McNeil, Deborah; Konschuh, Shaelen; Sycuro, Laura J.; McDonald, Sheila W.
    Abstract Background Evidence of associations between prenatal cannabis use (PCU) and maternal and infant health outcomes remains conflicting amid broad legalization of cannabis across Canada and 40 American states. A critical limitation of existing evidence lies in the non-standardized and crude measurement of prenatal cannabis use (PCU), resulting in high risk of misclassification bias. We developed a standardized tool to comprehensively measure prenatal cannabis use in pregnant populations for research purposes. Methods We conducted a mixed-methods, patient-oriented tool development and validation study, using a bias-minimizing process. Following an environmental scan and critical appraisal of existing prenatal substance use tools, we recruited pregnant participants via targeted social media advertising and obstetric clinics in Alberta, Canada. We conducted individual in-depth interviews and cognitive interviewing in separate sub-samples, to develop and refine our tool. We assessed convergent and discriminant validity internal consistency and 3-month test–retest reliability, and validated the tool externally against urine-THC bioassays. Results Two hundred fifty four pregnant women participated. The 9-item Cannabis Exposure in Pregnancy Tool (CEPT) had excellent discriminant (Cohen’s kappa = -0.27–0.15) and convergent (Cohen’s kappa = 0.72–1.0) validity; as well as high internal consistency (Chronbach’s alpha = 0.92), and very good test–retest reliability (weighted Kappa = 0.92, 95% C.I. [0.86–0.97]). The CEPT is valid against urine THC bioassay (sensitivity = 100%, specificity = 82%). Conclusion The CEPT is a novel, valid and reliable measure of frequency, timing, dose, and mode of PCU, in a contemporary sample of pregnant women. Using CEPT (compared to non-standardized tools) can improve measurement accuracy, and thus the quality of research examining PCU and maternal and child health outcomes.
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    Exploring the Relationships Among Extracurricular Activities, Cultural Connectedness and School Engagement Among First Nations Youth
    (2018-10-30) Campbell, Ian Stewart; Schwartz, Kelly Dean; McMorris, Carly A.; Brandon, Jim
    The current study set out to identify the relationships among school engagement, structured extracurricular activities, and cultural connectedness within a sample of Indigenous youth. Eighteen First Nations youth living in Stoney Nakoda Nation completed a demographics question questionnaire (i.e., extracurricular activities, age of participant, and who the child resides with), a school engagement measure (including behavioural, emotional, and cognitive engagement), and a cultural connectedness scale. Although no significant results were found, First Nations youth are participating in structured extracurricular activities in the form of in-school sports and out of school sports. Emotional engagement and school engagement total were moderately correlated to extracurricular activity participation. Cultural connectedness was not significantly related to extracurricular activity participation or school engagement. Furthermore, cultural connectedness did not significantly moderate the relationship between school engagement and extracurricular activities across any of its levels. Interpretations of these findings, as well as limitations and implications are provided. Keywords: Extracurricular activities, school engagement, emotional engagement, behavioural engagement, cognitive engagement, cultural connectedness, First Nations.
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    Exploring Trajectories of Language Development in Children with Autism Spectrum Disorder Across Multiple Measures
    (2020-09-06) Hart, Chelsie Miko; Curtin, Suzanne; Graham, Susan A.; McMorris, Carly A.; McCrimmon, Adam W.
    Autism Spectrum Disorder (ASD) is a developmental disability that affects the cognitive development of up to 1 in 59 children globally, particularly in language abilities (Baio et al., 2018). With increasing prevalence and research showing the benefits of early intervention, there is value in diagnosing ASD as soon as possible. However, ASD is typically not diagnosed until after age two, when many developmental milestones should have passed and parental concerns may have already risen (Falck-Ytter, 2012; Landa et al., 2013). Research must include measures from earlier in childhood to improve diagnosis methods and capture a full picture of this disability. This study examined how different language measures capture the range of expressive and receptive language vocabulary in children from 6 to 36 months of age; longitudinally comparing children eventually diagnosed with ASD to typically developing peers. Children were assessed repeatedly using the Mullen Scales of Early Learning (MSEL; Mullen, 1995), MacArthur-Bates Communicative Development Inventory (CDI; Fenson et al., 2007), and One-Word Picture Vocabulary Tests (PVT; Martin & Brownell, 2011a; 2011b). Results from mixed regression analysis showed that most measures could distinguish children with ASD as a group by 24 months. However, the Expressive PVT did not distinguish the ASD group from typically developing groups, despite being correlated with all other measures. Further examination of individual trajectories for children with ASD showed high, but inconsistent heterogeneity from scale to scale. This combination of varying group and individual differences suggests that these common assessments may not capture children’s abilities in the same way or to the same extent. Thus, this study supports that, to accurately observe the wide range developmental trajectories seen in ASD, professionals must consider the characteristics of the tools being used. Capturing this developmental variability is vital for creating effective targeted early interventions.
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    Factors Contributing to Late Diagnosis in Females with Autism Spectrum Disorder
    (2019-10-21) Aitken, Amanda; McMorris, Carly A.; Backenson, Erica M.; Curtin, Suzanne
    Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in communication and social relationships, and rigid and repetitive behaviours. The age at which an individual is diagnosed directly affects access to important resources, including early intervention, school program planning, and overall functioning for both the child and family. Children who receive an ASD diagnosis at an older age (i.e., 5 years of age or older) may miss out on early supports and funding. There are many factors that can impact the age at which a child receives an ASD diagnosis, including cognitive and adaptive functioning, severity of ASD symptoms, and the complexity of symptoms a child presents with. Children with higher cognitive and adaptive functioning, milder ASD symptoms, and fewer co-occurring mental health and developmental disorders often receive a diagnosis of ASD at an older age. However, existing literature on how these clinical factors impact diagnosis in females with ASD is mixed. As females typically receive a diagnosis of ASD at an older age compared to males, understanding what factors contribute to this delay that are unique to this population is essential to ensure early access to intervention. Thus, the purpose of this study was to replicate previous research showing that females receive a diagnosis at an older age than males, as well as clinical factors (e.g., cognitive functioning, ASD symptom severity, and adaptive functioning) that might impact late diagnosis, particularly in females. Psychological reports of 58 males and 32 females seen at the Autism Spectrum Disorder Diagnostic Clinic (Calgary, AB) for a comprehensive assessment were reviewed in order to obtain information regarding cognitive and adaptive functioning, ASD symptom severity, and co-occurring diagnoses. Inconsistent with previous research and our hypothesis, females did not receive a diagnosis of ASD at an older age (M = 10.7, SD = 48.74) than males (M = 9.6, SD = 32.22), nor did ASD symptom severity or adaptive functioning predict receiving a diagnosis later in life; however, cognitive functioning and number of co-occurring disorders did predict age at diagnosis. Biological sex did not influence any of these relationships.
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    Neurobiological Correlates of Anxiety and Comorbid Social Phobia in Adolescents with Major Depressive Disorder: A Repetitive Transcranial Magnetic Stimulation Clinical Trial
    (2018-10-03) Worth, Madelyn Reid; Schwartz, Kelly Dean; MacMaster, Frank P.; Exner-Cortens, Deinera; McMorris, Carly A.; Schwartz, Kelly Dean; MacMaster, Frank P.
    This study examined repetitive transcranial magnetic stimulation (rTMS) as a treatment for adolescents with major depressive disorder. The study was exploratory, considering the potential influence of comorbid anxiety on treatment response and neurobiological correlates. Adolescents underwent a three-week rTMS clinical trial. Depression and anxiety symptoms were compared pre- and post-treatment to determine treatment response. As well fMRI scans were reviewed, identifying functional connectivity differences based upon comorbid anxiety. Findings indicated a significant relation between depressive symptom response and comorbid social phobia symptoms such that participants without social phobia symptoms were more likely to show a significant reduction in depressive symptoms. Neurobiological differences in terms of functional connectivity were found, based upon anxiety severity, comorbid social phobia symptoms, and anxiety symptom treatment response. These findings indicate that the presence of comorbid anxiety is associated with neurobiological differences that may in turn influence rTMS treatment response. Discussions of these findings are included in this document.
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    Retired Spouses of Public Safety Personnel in a Psychologist-Facilitated Support Group: Trends of Individual and Group Change
    (2020-07-22) Baek, Cheong-Min; Schwartz, Kelly Dean; McMorris, Carly A.; Makarenko, Erica
    The current study investigated the effectiveness of the facilitated support group provided to spouses of retired Veterans, firefighters, and correctional officer who are affected by Occupational Stress Transmission provided by WGM Psychological Services in Calgary for 12 months. A total of six participants provided consent to this study, and their Outcome Questionnaire and Group Questionnaire data were collected to examine the symptoms experienced and therapeutic relationships experienced by participants during the therapy. Specifically, the Outcome Questionnaire measured participants’ symptom distress (i.e., discomfort, depression, and anxiety levels), interpersonal relations (i.e., loneliness, conflict with others, and marriage and family difficulties), and social role (i.e., difficulties across different settings); and the Group Questionnaire measured positive bonding relationship, positive working relationship, and negative relationships to evaluate therapeutic relationships between member to leader, member to member, and member to group. The current study investigated if individuals showed change in symptoms, if all participants showed reduction in symptom as a group, if individuals showed improved therapeutic relationships during the therapy, and if therapeutic relationships impacted the successfulness of the professionally facilitated support group. The current study could not utilize a statistical analysis; therefore, the scores were analyzed by trend analysis (i.e., visual analysis of graphs), and utilizing score sorting system and pre-existing sample scores to identify any change to severity of symptoms. The results indicated that five participants experienced reduction in symptoms, therapeutic relationships were stable throughout the therapy, and the variables of therapeutic relationship was found to have no measurable impact on symptom change. The current study had limitations due to the format of the data, more depth interpretation and discussion of the findings, along with implications and future directions are provided in the study.
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    Strong Bodies, Strong Minds? The Relation Between Coping Style and Physical Health Outcomes Among Special Olympic Athletes
    (2020-09-25) Hewitt, Katherine J.; McMorris, Carly A.; Weiss, Jonathan; McDonough, Meghan
    Background: Intellectual disability (ID) affects one to three percent of the global population (Harris, 2009) and is a lifelong neurodevelopmental condition with limitations in cognitive functioning and adaptive behaviour beginning in the developmental period (American Psychiatric Association [APA], 2013). Individuals with ID are known to have poorer health and greater health needs, including co-occurring physical and mental health conditions; however, the latter is less understood. Despite this, the link between the mental and physical health among individuals with ID is not well known. In the general population, how individuals cope with stress, and active coping strategies in particular, has been linked to both improved well-being and physical health. This thesis addressed this substantial gap by investigating the types of coping strategies reported by elite Special Olympic (SO) athletes and their subsequent relation to body mass index (BMI) and blood pressure. Methods: For this exploratory study, a secondary data analysis was conducted using the Special Olympic Healthy Athlete’s database from the World Games in Abu Dhabi in March 2019. Specifically, de-identified records were obtained and analysed for elite SO athletes who participated in Strong Minds and Health Promotion health screenings. Coping style was obtained by a single open-ended question. In the first study, the types of coping strategies reported by SO athletes who attended Strong Minds screenings were described by available sample demographics (age, gender, and geographical world region). In the second study, a subsample of athletes who attended both Strong Minds and Health Promotion screenings were included. Differences between coping style (active, avoidant, neither/no coping styles) on two physical health indicators, BMI and mean arterial blood pressure (MAP), were explored while controlling for age. Results: 2,626 athletes were included in the first study. Over half (56%) of athletes reported active coping strategies, 16% reported avoidant strategies, 8% reported the use of both active and avoidant strategies and 20% reported no coping strategies. Chi-square analyses found that while age and gender were unrelated to coping style, there was a statistically significant association between geographical region and coping style, χ2 (1, N = 2,626) = 59.52, p < .001. For the second study, 651 athlete records were analyzed and, similar to Paper 1, the majority of athletes reported active coping strategies (62%). Forty-six percent of participants’ BMI fell in the average range, and 89% of participants had average MAP ratings. Results from the MANCOVA revealed that BMI and MAP did not significantly differ between coping styles, F(4,1294) = 1.35, p = .249, Wilks’ Λ = .992, partial η2= .004. Conclusion: This thesis is the first of its kind to examine the link between coping strategies reported by elite SO athletes in response to a stressful situation, and physical health indicators. Unexpectedly, there was no association between coping style, BMI, and MAP, even after accounting for age. Limitations in the measurement of coping and lack of information on important confounding variables (e.g., medications, severity of ID) restrict the generalizability of these findings. However, coping strategy is an important factor in the health and well-being of individuals with and without ID, and more research is needed to help inform prevention of mental health issues in this already vulnerable population.
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    Transdiagnostic Associations Between Motor and Language Abilities in Children with Developmental Disabilities
    (2020-09-14) Vashi, Nisha Bhupendra; Curtin, Suzanne; McMorris, Carly A.; Pexman, Penny M.; Schwartz, Kelly Dean
    Theoretical perspectives and empirical evidence provide support for the relationship between motor and language abilities in typically and atypically developing children. Few studies have explored whether these associations persist across diagnosis, and whether there are profiles based on subtypes of motor and language abilities. The present study had the following aims: 1) is there an association between motor and language abilities across diagnosis; 2) are there associations between fine motor, gross motor, receptive language, and expressive language abilities across diagnosis; and 3) based on these associations between fine motor, gross motor, receptive language and expressive language, are there profiles of scores related to these abilities? Children with various developmental disabilities (e.g. autism spectrum disorder, language delay, cerebral palsy, Down syndrome, global developmental delay) were recruited at Renfrew Educational Services. Transdisciplinary teams administered the Carolina Curriculum for Infants, Toddlers, and Preschoolers with Special Needs, Second & Third Edition over a two-week period. Associations were demonstrated between overall motor and overall language abilities across diagnosis. Fine motor abilities were associated with and predicted receptive and expressive language. Gross motor abilities were associated with and predicted expressive language, but not receptive language. Four clusters of scores related to the subtypes of motor and language abilities emerged. Adopting a transdiagnostic approach provides a more realistic and comprehensive understanding of programming and intervention for children with developmental disabilities. Future studies are needed to ascertain whether these transdiagnostic associations persist over time.