Nuri M Reyes - Academia.edu (original) (raw)

Select Publications by Nuri M Reyes

The Child Behaviour Checklist (CBCL/6-18) is a 113-item parent report measure designed to assess ... more The Child Behaviour Checklist (CBCL/6-18) is a 113-item parent report measure designed to assess behavioural and emotional problems in children and young people aged 6-18 years. This most recent version of the original measure includes items and subscales aimed at assessing symptoms of anxiety, depression, somatic complaints (that is, physiological symptoms frequently associated with internalising behaviours like anxiety and depression), social problems, thought problems, attention problems, rule-breaking behaviour and aggressive behaviour. The CBCL is part of the Achenbach System of Empirically Based Assessment (ASEBA). Psychometric features Internal consistency Test-retest reliability Validity Sensitivity to change ✓ (Scale) ✓ (Subscale) ✓ ✓ ✓ Implementation features Brevity Availability Ease of Scoring Used in the UK ✕ ✕ ✕ ✓ *Please note that our assessment of this measure is based solely on the English version of the CBCL/6-18. The other versions were not assessed and therefore, it should not be assumed that they would receive the same rating. What is this document? This assessment of the Child Behaviour Checklist (CBCL/6-18) has been produced by the Early Intervention Foundation (EIF) as part of guidance on selecting measures relating to parental conflict and its impact on children. To read the full guidance report and download assessments of other measures, visit: https://www.eif.org.uk/resource/measuring-parental-conflict-and-its-impact-on-child-outcomes Some of the CBCL items contain sensitive content (for example item 18: 'deliberately harms self or attempts suicide'). If an individual raises issues around self-harm, suicide or related issues, they should either be referred to the relevant mental health services or the appropriate safeguarding procedures should be put in place.

Journal of Autism and Developmental Disorders, 2017

Knowledge of why parents use complementary health approaches (CHA) for children with autism spect... more Knowledge of why parents use complementary health approaches (CHA) for children with autism spectrum disorder (ASD) is limited. We conducted a mixed methods study to better understand factors influencing parents' decision to use CHA for ASD. Parent-reported data about CHA use were collected on a probability sample of 352 young children with ASD in Denver, Colorado; Los Angeles, California; or Portland, Oregon. Follow-back interviews were conducted with 31 parents. CHA use was negatively associated with older child age and positively associated with parents' belief ASD has major consequences, living in Portland or Denver, and medication use. Nine themes help explain these results. Study findings may have utility for healthcare providers working with children with ASD and their families regarding CHA.

Papers by Nuri M Reyes

INSAR 2018 Annual Meeting, May 10, 2018

This study aimed to investigate differences between emotion regulation (ER), emotionality, and ex... more This study aimed to investigate differences between emotion regulation (ER), emotionality, and expression of emotions in children with Autism Spectrum Disorder (ASD) and their typically developing (TD) peers; and to examine the potential links between these areas of development with social skills in both groups, as well as with behavioral, emotional, and social problems in ASD. Forty-four children (40 males and 4 females, ages 3 to 7 years) with ASD (n = 22) and their TD peers (n = 22) were included in this study. Mothers reported about their children's ASD symptoms, social, emotional, and behavioral functioning. As predicted, children with ASD were described as showing decreased ER, increased emotionality, and decreased expression of emotions when compared to their TD peers. Moreover, in the ASD group, increased social skills were associated with enhanced ER and increased expression of emotions; and in the TD group, increased social skills were correlated with decreased emotionality. Finally, enhanced ER was linked to decreased peer problems, and increased prosocial behaviors; and decreased emotionality was linked to decreased behavior and emotional problems in the ASD group. Implications for further research are discussed.

American Academy of Pediatrics eBooks, Oct 2, 2020

OBJECTIVES: To compare barriers to autism spectrum disorder (ASD) diagnosis and current ASD-relat... more OBJECTIVES: To compare barriers to autism spectrum disorder (ASD) diagnosis and current ASD-related service use among non-Latino white (NLW) families and Latino families with English proficiency (L-EP) or limited English proficiency (L-LEP). METHODS: We conducted a mixed-mode survey of families of children with confirmed ASD seen at specialty clinics in 3 United States cities. Bivariate and multivariate analyses compared barriers to ASD diagnosis, current service use, and unmet therapy need among NLW, L-EP, and L-LEP families. RESULTS: Overall, barriers to ASD diagnosis were prevalent: families (n = 352) experienced a mean of 8 of 15 barriers to ASD diagnosis. The most prevalent barriers overall were "stress of diagnostic process, " "parent knowledge about ASD, " and "understanding medical system." Compared with NLW families, L-LEP families were more likely to experience barriers related to knowledge about ASD and trust in providers. Children in L-LEP families also had fewer current therapy hours and more unmet therapy needs than children in NLW families. L-EP families' barriers and treatment services use profile was more similar to NLW than to L-LEP families. CONCLUSIONS: English proficiency was an important marker for barriers to ASD diagnosis and treatment in Latinos. Increasing ASD-related knowledge and provider trust may decrease disparities in the diagnosis and treatment of ASD among US Latinos.

Autism, May 19, 2023

Autistic youth frequently experience interfering anxiety, and schools may be an ideal setting to ... more Autistic youth frequently experience interfering anxiety, and schools may be an ideal setting to deliver mental health care. A type 1 hybrid-effectiveness, cluster randomized trial was used to examine the effectiveness of school-based Facing Your Fears compared to usual care. Change in provider cognitive behavior therapy knowledge and treatment fidelity (adherence and provider competence) were also examined. Seventy-seven interdisciplinary school providers across 25 elementary/middle schools were trained via a train-the-trainer approach. Eighty-one students, ages 8–14 years, with autism or suspected autism and anxiety participated. Students who received school-based Facing Your Fears displayed significantly greater reductions in anxiety compared to students in usual care according to caregiver and child report (Screen for Anxiety and Related Emotional Disorders). Significant reductions in total anxiety ( p = 0.012), separation ( p = 0.002), and social anxiety ( p = 0.003) subscales occurred, according to parent report. Student self-report indicated significant reductions on the social anxiety subscales ( p = 0.001). Interdisciplinary school providers demonstrated significantly increased cognitive behavior therapy knowledge following training ( p < 0.001). Mean adherence and competence ratings were strong. The positive effectiveness and implementation outcomes are encouraging. Training interdisciplinary school providers to deliver school-based Facing Your Fears has the potential to increase access to care for anxious autistic students. Future directions and limitations are discussed. Lay Autistic youth frequently experience anxiety that can negatively affect them at home, with friends, and at school. Autistic youth have difficulty accessing mental health care, and this is particularly true for youth from traditionally underserved backgrounds. Providing mental health programs in schools may increase access to care for autistic youth with anxiety. The purpose of the study was to train interdisciplinary school providers to deliver school-based Facing Your Fears, a cognitive behavior therapy program for anxiety in autistic youth. Seventy-seven interdisciplinary school providers across 25 elementary/middle schools were trained by their colleagues and members of the research (train-the-trainer approach). Eighty-one students with autism or suspected autism, ages 8–14 years, were randomly assigned to either school-based Facing Your Fears or usual care. Students in school-based Facing Your Fears showed significant reductions in anxiety compared to students in usual care according to caregiver and student report. Other measures involved examining change in provider cognitive behavior therapy knowledge after training and determining how well interdisciplinary school providers were able to deliver school-based Facing Your Fears. Results indicated that interdisciplinary school providers showed significant improvements in cognitive behavior therapy knowledge after training. Interdisciplinary school providers were able to deliver most of school-based Facing Your Fears activities and with good quality. The positive outcomes in this study are encouraging. Training interdisciplinary school providers to deliver school-based Facing Your Fears may increase access to care for anxious autistic students. Future directions and limitations are discussed.

Journal of Developmental & Behavioral Pediatrics

ABSTRACT: Objective: Understanding how the COVID-19 pandemic affected children with disabilities ... more ABSTRACT: Objective: Understanding how the COVID-19 pandemic affected children with disabilities is essential for future public health emergencies. We compared children with autism spectrum disorder (ASD) with those with another developmental disability (DD) and from the general population (POP) regarding (1) missed or delayed appointments for regular health/dental services, immunizations, and specialty services; (2) reasons for difficulty accessing care; and (3) use of remote learning and school supports. Method: Caregivers of children previously enrolled in the Study to Explore Early Development, a case-control study of children with ASD implemented during 2017 to 2020, were recontacted during January–June 2021 to learn about services during March–December 2020. Children were classified as ASD, DD, or POP during the initial study and were aged 3.4 to 7.5 years when their caregivers were recontacted during the pandemic. Results: Over half of all children missed or delayed regular h...

The Journal of Pediatrics, 2021

Objectives-To explore how many preschool aged children with autism spectrum disorder (ASD) used p... more Objectives-To explore how many preschool aged children with autism spectrum disorder (ASD) used psychotropic medication, child and geographic factors associated with psychotropic medication use, and how many children who used psychotropic medication did or did not ever receive behavior therapy. Study design-Children 2-5 years of age were enrolled from 2012 to 2016 in a multisite casecontrol study designed to investigate the development and risk factors of ASD. Children with a positive ASD screen or ASD diagnosis upon enrollment were asked to complete a comprehensive evaluation to determine ASD status and developmental level. Caregivers completed a Services and Treatments Questionnaire and multiple self-administered questionnaires to determine child use of psychotropic medication, ever receipt of behavior therapy, and presence of co-occurring symptoms. Results-There were 763 children who were classified as ASD and had data collected on the Services and Treatments Questionnaire. Of those, 62 (8.1%) used psychotropic medication to treat behavioral symptoms and 28 (3.7%) were ≤3 years of age when medication was first started.

Autism, 2021

Cognitive behavioral therapy for youth with autism spectrum disorder and anxiety is effective, bu... more Cognitive behavioral therapy for youth with autism spectrum disorder and anxiety is effective, but disparities exist in accessing these programs. Training school providers to deliver cognitive behavioral therapy may help to address these disparities. However, little is known about how cognitive behavioral therapy programs are implemented by interdisciplinary school providers and the broader impact of these programs. This study aimed to address this gap and was part of a larger trial that examined the effectiveness of Facing Your Fears–School-Based across 25 public schools. Study aims were to understand the impact of Facing Your Fears–School-Based and factors that impacted implementation. Thirty providers participated in exit interviews guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Primary themes included (1) the fit of Facing Your Fears–School-Based for diverse students; (2) the effects of Facing Your Fears–School-Based on students’ school ...

Interprofessional Care Coordination for Pediatric Autism Spectrum Disorder, 2020

Despite dramatic demographic changes over the past five decades specifically, culturally and ling... more Despite dramatic demographic changes over the past five decades specifically, culturally and lingustically diverse (CLD) children are more likely to receive delayed diagnosis and misidentification of ASD as well as experience significant barriers to obtaining ASD services in general. Delays in ASD identification or intervention provision can negatively impact future outcomes and may indicate that professionals are missing important cultural or linguistic considerations when providing services to CLD children and families. Strong interdisciplinary care practices can improve the outcomes of CLD children and their families with ASD. This chapter presents the challenges and successes to the facilitation of interdisciplinary care among CLD children. As services for ASD most often occur in clinical and school-based settings, the chapter will focus on both settings. Recommendations for culturally and linguistically responsive interdisciplinary care for children with ASD are provided.

School Psychology Review, 2021

This study examined child and family factors that may influence the Social Communication Question... more This study examined child and family factors that may influence the Social Communication Questionnaire (SCQ) in English- and Spanish-speaking samples. A total of 199 English- or Spanish-speaking mo...

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School Mental Health, 2019

Anxiety disorders are among the most common co-occurring psychiatric conditions for youth with AS... more Anxiety disorders are among the most common co-occurring psychiatric conditions for youth with ASD (van Steensel et al. in Clin Child Fam Psychol Rev 14:302-317, 2011). Although modified cognitive behavioral therapies (CBT) have yielded significant reductions in anxiety, substantial disparities in access to mental health services exist for youth from diverse and low-income families. Schools represent a consistent resource for underserved communities; thus, there is a critical need to adapt and implement CBT programs in school settings. Engaging stakeholders in the initial phase of adaptation is essential to support adoption and sustainability of best practice interventions in schools. The primary purpose of the study was to adapt group CBT (Facing Your Fears (FYF); Reaven et al. in Facing your fears: group therapy for managing anxiety in children with high-functioning autism spectrum disorders, Paul Brookes Publishing, Baltimore, 2011) via iterative processes with key stakeholders to create a feasible, effective, and sustainable school-based program to manage anxiety in underserved students with ASD. Two rounds of parent and professional focus groups were conducted across three school districts (total 14 groups), using qualitative content analysis methodology. Details regarding the delivery of FYF, selection of students, training considerations for staff, and identifying meaningful outcomes were obtained in anticipation of an implementation trial of FYF.

Autism, 2018

Results of randomized controlled trials have demonstrated significant reductions in anxiety sympt... more Results of randomized controlled trials have demonstrated significant reductions in anxiety symptoms following cognitive behavior therapy participation. Although promising, the extent to which previous research has included families from low socioeconomic status or racially/ethnically diverse backgrounds is unknown. Aims of this study are as follows: (1) What is the race, ethnicity, and educational attainment of youth with autism spectrum disorder and their families who have participated in research examining the efficacy of cognitive behavior therapy for anxiety? and (2) How do the demographics of these participants compare to that of the United States census? A total of 14 studies were reviewed that included 473 participants. Chi-square analyses indicated that there are significant differences between the race/ethnicity of youth with autism spectrum disorder participating in cognitive behavior therapy research for anxiety and that of youth in the United States. Standard residuals ...

Journal of Abnormal Child Psychology, 2018

This study explored whether ASD phenotypes in the child were associated with a history of anxiety... more This study explored whether ASD phenotypes in the child were associated with a history of anxiety or depression in the mother. We hypothesized that an ASD profile in children characterized by mild delays and increased rates of dysregulation would be associated with preexisting maternal anxiety or depression. Participants were 672 preschool children with ASD and their mothers. Children were classified as ASD after a comprehensive developmental evaluation. Mothers reported whether a healthcare provider ever diagnosed them with anxiety or depression before the birth of their child. Four child ASD phenotypes were derived from latent class analysis: Mild Language Delay with Cognitive Rigidity (Type 1), Significant Developmental Delay with Repetitive Motor Behaviors (Type 2), General Developmental Delay (Type 3), and Mild Language and Motor Delay with Dysregulation (i.e., aggression, anxiety, depression, emotional reactivity, inattention, somatic complaints, and sleep problems) (Type 4). Type 2 ASD served as the referent category in statistical analyses. Results showed that 22.6% of mothers reported a diagnosis of anxiety or depression before the birth of their child. Maternal anxiety or depression was associated with 2.7 times the odds (95% confidence interval: 1.4, 5.3) of Type 4 or Dysregulated ASD in the child; maternal anxiety and depression was associated with 4.4 times the odds (95% confidence interval: 1.4, 14.0) of Type 4 or Dysregulated ASD in the child. Our findings suggest an association between Dysregulated ASD in the child and anxiety and depression in the mother. These findings can enhance screening methods and inform future research efforts.

Journal of autism and developmental disorders, Jan 14, 2017

Supplemental material, AUT795678_Lay_Abstract for Examining the inclusion of diverse participants... more Supplemental material, AUT795678_Lay_Abstract for Examining the inclusion of diverse participants in cognitive behavior therapy research for youth with autism spectrum disorder and anxiety by Katherine Pickard, Nuri Reyes and Judy Reaven in Autism

Journal of Autism and Developmental Disorders, 2017

INSAR 2018 Annual Meeting, May 10, 2018

American Academy of Pediatrics eBooks, Oct 2, 2020

Autism, May 19, 2023

Journal of Developmental & Behavioral Pediatrics

The Journal of Pediatrics, 2021

Autism, 2021

Interprofessional Care Coordination for Pediatric Autism Spectrum Disorder, 2020

School Psychology Review, 2021

School Mental Health, 2019

Autism, 2018

Journal of Abnormal Child Psychology, 2018

Journal of autism and developmental disorders, Jan 14, 2017

There is often a large time gap between caregivers’ initial concerns and the diagnosis of autism ... more There is often a large time gap between caregivers’ initial concerns and the diagnosis of autism spectrum disorder. The current study aimed to identify factors associated with missed or delayed autism spectrum disorder diagnoses among children in Colorado. In a surveillance-based sample of 8-year-old children with autism spectrum disorder (N = 572), we examined differences between children who were identified with autism spectrum disorder by a community provider and/or were eligible for special education services under an autism eligibility (documented diagnosis) and children who were first identified with autism spectrum disorder through a systematic record review (newly identified). Compared to documented diagnosis children, newly identified children were more likely to be female, aggressive, and argumentative. They were less likely to have had a developmental regression, sleep abnormalities, or an autism screener or diagnostic measure in their records. Newly identified children a...