Eldon Schulz - Profile on Academia.edu (original) (raw)
Papers by Eldon Schulz
Financial and employment impact of intellectual disability on families of children with autism
Families, Systems, & Health, 2015
Families of children with autism spectrum disorder (ASD) endure significant financial and employm... more Families of children with autism spectrum disorder (ASD) endure significant financial and employment burden because of their children's numerous needed services. The study objective is to describe additional impact on families of children with intellectual disability (ID) in addition to ASD. The study is a secondary data analysis of the 2009-2010 National Survey of Children with Special Health Care Needs. Children whose parents answered "yes" when asked whether their child had ASD or ID were classified as having ASD alone (unweighted n = 2,406), ID alone (unweighted n = 1,363), or both ASD/ID (unweighted n = 620). Bivariate and multivariate analyses compared study outcomes of family financial and caregiver burden using ASD as the reference group. All analyses were weighted using person-level estimates. Of children with ASD, 24% also had ID. More than half of caregivers of children with ASD/ID reported financial difficulty (52%) and having to stop work to care for their child (51%). Compared with ASD alone, caregivers of children with both ASD/ID were more likely to report financial difficulty (aOR 1.65, 95% CI 1.10-2.46), cutting work hours (aOR 1.43, 95% CI .98-2.08), and stop working (aOR 2.32, 95% CI 1.57-3.43). No differences were found between caregivers of children with ASD only and ID only. We conclude that having ID in addition to ASD may be associated with greater negative impact on family financial and employment burden. Recognition of ID in addition to ASD is important to tailor the clinical approach and sufficiently support families. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
The need for educational assessment of children entering foster care
Child welfare
Comprehensive medical and mental health evaluations of children in foster care are recommended wi... more Comprehensive medical and mental health evaluations of children in foster care are recommended within 30 days of entering care. What constitutes a comprehensive evaluation has yet to be established. This study examines the need to include educational assessment as a component of the comprehensive evaluation. Rates of achievement and language problems for Arkansas school-age children are compared with rates of medical and psychiatric disorders to assess the relative need for including educational assessment.
The Arkansas Autism Developmental Disabilities Monitoring (AR ADDM) project: statewide autism surveillance in a rural state
The Journal of the Arkansas Medical Society, 2012
In 2002, the Arkansas Autism and Developmental Disabilities Monitoring (AR ADDM) project collecte... more In 2002, the Arkansas Autism and Developmental Disabilities Monitoring (AR ADDM) project collected data on the number and characteristics of resident children aged 8 years using a retrospective record review standardized methodology. This paper provides a first-look epidemiology of ASDs among 8 year old Arkansas children using data from the 2002 study year. Overall prevalence estimates, demographic distribution and a temporal lag from concerns identified to diagnosis of ASDs among 8 year olds in Arkansas were similar to that in other sites. Dissemination of information that promotes timely resolution of developmental concerns and improving educational services will benefit children with autism in Arkansas.
PRENATAL ALCOHOL EXPOSURE AND COMMUNICATION, BEHAVIOR, AND NONVERBAL INTELLIGENCE OF 3 SCHOOL-AGE CHILDREN
Perceptual and Motor Skills, 1998
Associations of prenatal alcohol exposure in speech, language, behavioral, and intellectual devel... more Associations of prenatal alcohol exposure in speech, language, behavioral, and intellectual development were investigated in three school-aged children diagnosed with Fetal Alcohol Syndrome, accompanied by Attention Deficit Hyperactivity Disorder. Each child showed similar patterns of moderate-to-severe dysfunctional behavior; however, their scores on speech, language and nonverbal intellectual measures were highly variable.
Neuroscience, 1989
The distribution of both monoamine oxidase subtypes, monoamine oxidase-A and -B, is demonstrated ... more The distribution of both monoamine oxidase subtypes, monoamine oxidase-A and -B, is demonstrated in brainstems from 16 humans by use of a histochemical technique. The results presented here, focus primarily upon the aminergic areas of the substantia nigra, the locus coeruleus and the raphe nuclei. While dopaminergic neurons of the substantia nigra revealed no staining for monoamine oxidase, noradrener~c neurons of the locus coeruleus stained positively with the monoamine oxidase-A substrate serotonin, and serotonergic neurons of the raphe nuclei were stained by the monoamine oxidase-B substrate ~-phenylethylamine. In addition, data are presented showing that glial cells stain predomifrantly for monoamine oxidase-B.
How Accurate are Clinical Impressions, Based on a Parent Interview and Informal Observation of the Child in Clinic, in the Assessment of Attention Deficit Hyperactivity Disorder?
Journal of Developmental & Behavioral Pediatrics, 2010
Journal of Abnormal Child Psychology, 2007
This study evaluated the validity and classification utility of the Conners&a... more This study evaluated the validity and classification utility of the Conners' Continuous Performance Test (CCPT) in the assessment of inattentive and hyperactive-impulsive behaviors in children. Significant, positive correlations between the CCPT parameters and behavioral ratings of ADHD behaviors were hypothesized. In addition, it was hypothesized that the CCPT parameters would perform better than a random test (chance) and show fair to moderate utility of classification across the different indices. Participants were 104 children between 6 and 12 years of age who were referred for evaluation of attention problems. The first hypothesis was not supported. There were no significant, positive correlations between the CCPT parameters and parent and teacher ratings of inattentive and hyperactive-impulsive behaviors. The second hypothesis was only partially supported. The CCPT Overall Index and the Omission Errors (84th percentile cutoff) performed better than a random test; however, the utility of the CCPT Overall Index only ranged from poor to slight. Receiver operating characteristic analyses showed the accuracy of the CCPT to be low. The implications and limitations of this study and future research directions are discussed.
Experimental and Clinical Psychopharmacology, 2002
The effect of stimulant medication on recognition memory was examined in 18 children with attenti... more The effect of stimulant medication on recognition memory was examined in 18 children with attention-deficit/hyperactivity disorder (ADHD). Recognition memory was assessed using a delayed matching-to-sample task at 6 delays ranging from 1 to 32 s. Each child was tested on 2 separate occasions, once 60 to 90 min after taking stimulant medication and the other at least 18 hr after taking medication. Children performed significantly better on medication than off. Stimulant administration significantly increased accuracy and the number of nickel reinforcers earned. Decreases in observing response latency and correct choice response latency occurred after taking stimulant medication. The results indicate that stimulant medication improved recognition memory for children with ADHD.
KIDSCARE: A Network for Children With Special Health Care Needs
Critical Reviews in Biomedical Engineering, 2000
In December 1997, Arkansas Medicaid in cooperation with Title V and Children's Me... more In December 1997, Arkansas Medicaid in cooperation with Title V and Children's Medical Services (CMS) implemented guidelines for the preauthorization of therapy services for Children with Special Health Care Needs (CSHCN). The University of Arkansas for Medical Sciences (UAMS) in partnership with Arkansas Medicaid (MCD), and Chidren's Medical Services (CMS) were given the charge of developing clinical practice guidelines for physical therapy (PT), occupational therapy (OT), and speech/language therapy (SLP) for this population based on primary diagnosis and age appropriateness. This process involved the implementation of a statewide, internet-based, clinical information support network. The objective of this article is to describe KIDSCARE, a clinical information support network, currently under development, for the determination of medical necessity and allocation of therapy services for CSHCN.
The role of the family in the assessment of attention deficit hyperactivity disorder
Clinical Psychology Review, 1995
The family plays an essential and primary role in the assessment of Attention Deficit Hyperactivi... more The family plays an essential and primary role in the assessment of Attention Deficit Hyperactivity Disorder (ADHD) in children. This article seeks to provide the clinician with an understanding of the families of children with ADHD and how the functioning of the family might impact the outcome of assessment. It does so by discussing the role of the family in
Estimates of the Validity and Utility of Unstructured Clinical Observations of Children in the Assessment of ADHD
Clinical Pediatrics, 2005
The purpose of this prospective study was to examine the validity and diagnostic utility of unstr... more The purpose of this prospective study was to examine the validity and diagnostic utility of unstructured clinic observations of attention deficit hyperactivity disorder (ADHD) behaviors in children. Results showed observations to be related to behavioral ratings of parents but not of teachers. The relationship between observations and parent ratings was stronger for hyperactive-impulsive than inattentive behaviors. The level of agreement between observations and classification of ADHD significantly exceeded chance levels only for parent measures of hyperactivity-impulsivity. Only parent measures predicted a diagnosis of ADHD at a rate that was significantly better than chance. Clinic observations were found to have consistently higher positive predictive power than negative predictive power. Clinical implications are discussed.
Seizure Occurrence in Children Diagnosed with ADHD
Clinical Pediatrics, 2001
B oth attention deficit hyperactivity disorder (ADHD) and epilepsy have impor-tant implications f... more B oth attention deficit hyperactivity disorder (ADHD) and epilepsy have impor-tant implications for a child's learning, social, and behavioral development. Children with ADHD have an increased risk for oppositional behavioral disorders, learning disabilities, emo-...
Differentiating Between Seizures and Attention Deficit Hyperactivity Disorder (ADHD) in a Pediatric Population
Clinical Pediatrics, 2002
... Jane Williams, PhD May L. Griebel, MD Gregory B. Sharp, MD Bernadette Lange, MD Tonya Phillip... more ... Jane Williams, PhD May L. Griebel, MD Gregory B. Sharp, MD Bernadette Lange, MD Tonya Phillips, MD Emily DelosReyes, MD Stephen ... diagnostic tests are in-conclusive or when children live in areas without ready access to video-EEG monitoring, the de-pendence on ...
The Annals of Pharmacotherapy, 2002
To determine whether cardiac indices are altered as assessed by 24-hour ambulatory blood pressure... more To determine whether cardiac indices are altered as assessed by 24-hour ambulatory blood pressure monitoring (ABPM) in male children receiving either chronic methylphenidate or dextroamphetamine/levoamphetamine (Adderall) therapy. Boys 7-11 years old who were receiving methylphenidate or Adderall for a minimum of 2 months were asked to participate. Subjects wore ambulatory blood pressure monitors for 24-hour periods both off and on stimulant therapy. Subjects (n = 17; 8 methylphenidate, 9 Adderall) were well matched. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate differed between off and on stimulant therapy (p < 0.05). DBP load calculated from ABPM reference data was increased significantly (9.0% +/- 5.6% on and 4.8% +/- 4.5% off therapy; p < 0.05) while subjects were taking Adderall. There was a trend toward a greater elevation in blood pressure load during awake hours and a more pronounced decrease during the asleep hours for periods on compared with off-stimulant therapy. This trend resulted in significant (p < 0.05) nocturnal dipping on-stimulant phases compared with off-stimulant therapy for both SBP and DBP (Adderall) and SBP (methylphenidate). Two subjects (1 Adderall, 1 methylphenidate) met the criteria to be considered hypertensive based both on mean awake and 24-hour blood pressure load assessments during their on-treatment period. One additional subject receiving Adderall therapy met the criteria to be considered hypertensive based on blood pressure load criteria while off therapy only. Positive correlation coefficients (p < 0.05) were found when comparing stimulant dose (mg/kg) with the percent change of mean SBP, DBP, and heart rate between off and on therapy (r = 0.56, 0.61, and 0.58, respectively). These preliminary data suggest that blood pressure and heart rate appear to be altered in male patients while receiving stimulant therapy for attention-deficit hyperactivity disorder. Blood pressure and heart rate screening and monitoring during stimulant therapy to determine whether alterations become clinically significant is encouraged.
Journal of Autism and Developmental Disorders, 2012
Oxidative stress and abnormal DNA methylation have been implicated in the pathophysiology of auti... more Oxidative stress and abnormal DNA methylation have been implicated in the pathophysiology of autism. We investigated the dynamics of an integrated metabolic pathway essential for cellular antioxidant and methylation capacity in 68 children with autism, 54 age-matched control children and 40 unaffected siblings. The metabolic profile of unaffected siblings differed significantly from case siblings but not from controls. Oxidative protein/DNA damage and DNA hypomethylation (epigenetic alteration) were found in autistic children but not paired siblings or controls. These data indicate that the deficit in antioxidant and methylation capacity is specific for autism and may promote cellular damage and altered epigenetic gene expression. Further, these results suggest a plausible mechanism by which pro-oxidant environmental stressors may modulate genetic predisposition to autism.
Financial and employment impact of intellectual disability on families of children with autism
Families, Systems, & Health, 2015
Families of children with autism spectrum disorder (ASD) endure significant financial and employm... more Families of children with autism spectrum disorder (ASD) endure significant financial and employment burden because of their children's numerous needed services. The study objective is to describe additional impact on families of children with intellectual disability (ID) in addition to ASD. The study is a secondary data analysis of the 2009-2010 National Survey of Children with Special Health Care Needs. Children whose parents answered "yes" when asked whether their child had ASD or ID were classified as having ASD alone (unweighted n = 2,406), ID alone (unweighted n = 1,363), or both ASD/ID (unweighted n = 620). Bivariate and multivariate analyses compared study outcomes of family financial and caregiver burden using ASD as the reference group. All analyses were weighted using person-level estimates. Of children with ASD, 24% also had ID. More than half of caregivers of children with ASD/ID reported financial difficulty (52%) and having to stop work to care for their child (51%). Compared with ASD alone, caregivers of children with both ASD/ID were more likely to report financial difficulty (aOR 1.65, 95% CI 1.10-2.46), cutting work hours (aOR 1.43, 95% CI .98-2.08), and stop working (aOR 2.32, 95% CI 1.57-3.43). No differences were found between caregivers of children with ASD only and ID only. We conclude that having ID in addition to ASD may be associated with greater negative impact on family financial and employment burden. Recognition of ID in addition to ASD is important to tailor the clinical approach and sufficiently support families. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
The need for educational assessment of children entering foster care
Child welfare
Comprehensive medical and mental health evaluations of children in foster care are recommended wi... more Comprehensive medical and mental health evaluations of children in foster care are recommended within 30 days of entering care. What constitutes a comprehensive evaluation has yet to be established. This study examines the need to include educational assessment as a component of the comprehensive evaluation. Rates of achievement and language problems for Arkansas school-age children are compared with rates of medical and psychiatric disorders to assess the relative need for including educational assessment.
The Arkansas Autism Developmental Disabilities Monitoring (AR ADDM) project: statewide autism surveillance in a rural state
The Journal of the Arkansas Medical Society, 2012
In 2002, the Arkansas Autism and Developmental Disabilities Monitoring (AR ADDM) project collecte... more In 2002, the Arkansas Autism and Developmental Disabilities Monitoring (AR ADDM) project collected data on the number and characteristics of resident children aged 8 years using a retrospective record review standardized methodology. This paper provides a first-look epidemiology of ASDs among 8 year old Arkansas children using data from the 2002 study year. Overall prevalence estimates, demographic distribution and a temporal lag from concerns identified to diagnosis of ASDs among 8 year olds in Arkansas were similar to that in other sites. Dissemination of information that promotes timely resolution of developmental concerns and improving educational services will benefit children with autism in Arkansas.
PRENATAL ALCOHOL EXPOSURE AND COMMUNICATION, BEHAVIOR, AND NONVERBAL INTELLIGENCE OF 3 SCHOOL-AGE CHILDREN
Perceptual and Motor Skills, 1998
Associations of prenatal alcohol exposure in speech, language, behavioral, and intellectual devel... more Associations of prenatal alcohol exposure in speech, language, behavioral, and intellectual development were investigated in three school-aged children diagnosed with Fetal Alcohol Syndrome, accompanied by Attention Deficit Hyperactivity Disorder. Each child showed similar patterns of moderate-to-severe dysfunctional behavior; however, their scores on speech, language and nonverbal intellectual measures were highly variable.
Neuroscience, 1989
The distribution of both monoamine oxidase subtypes, monoamine oxidase-A and -B, is demonstrated ... more The distribution of both monoamine oxidase subtypes, monoamine oxidase-A and -B, is demonstrated in brainstems from 16 humans by use of a histochemical technique. The results presented here, focus primarily upon the aminergic areas of the substantia nigra, the locus coeruleus and the raphe nuclei. While dopaminergic neurons of the substantia nigra revealed no staining for monoamine oxidase, noradrener~c neurons of the locus coeruleus stained positively with the monoamine oxidase-A substrate serotonin, and serotonergic neurons of the raphe nuclei were stained by the monoamine oxidase-B substrate ~-phenylethylamine. In addition, data are presented showing that glial cells stain predomifrantly for monoamine oxidase-B.
How Accurate are Clinical Impressions, Based on a Parent Interview and Informal Observation of the Child in Clinic, in the Assessment of Attention Deficit Hyperactivity Disorder?
Journal of Developmental & Behavioral Pediatrics, 2010
Journal of Abnormal Child Psychology, 2007
This study evaluated the validity and classification utility of the Conners&a... more This study evaluated the validity and classification utility of the Conners' Continuous Performance Test (CCPT) in the assessment of inattentive and hyperactive-impulsive behaviors in children. Significant, positive correlations between the CCPT parameters and behavioral ratings of ADHD behaviors were hypothesized. In addition, it was hypothesized that the CCPT parameters would perform better than a random test (chance) and show fair to moderate utility of classification across the different indices. Participants were 104 children between 6 and 12 years of age who were referred for evaluation of attention problems. The first hypothesis was not supported. There were no significant, positive correlations between the CCPT parameters and parent and teacher ratings of inattentive and hyperactive-impulsive behaviors. The second hypothesis was only partially supported. The CCPT Overall Index and the Omission Errors (84th percentile cutoff) performed better than a random test; however, the utility of the CCPT Overall Index only ranged from poor to slight. Receiver operating characteristic analyses showed the accuracy of the CCPT to be low. The implications and limitations of this study and future research directions are discussed.
Experimental and Clinical Psychopharmacology, 2002
The effect of stimulant medication on recognition memory was examined in 18 children with attenti... more The effect of stimulant medication on recognition memory was examined in 18 children with attention-deficit/hyperactivity disorder (ADHD). Recognition memory was assessed using a delayed matching-to-sample task at 6 delays ranging from 1 to 32 s. Each child was tested on 2 separate occasions, once 60 to 90 min after taking stimulant medication and the other at least 18 hr after taking medication. Children performed significantly better on medication than off. Stimulant administration significantly increased accuracy and the number of nickel reinforcers earned. Decreases in observing response latency and correct choice response latency occurred after taking stimulant medication. The results indicate that stimulant medication improved recognition memory for children with ADHD.
KIDSCARE: A Network for Children With Special Health Care Needs
Critical Reviews in Biomedical Engineering, 2000
In December 1997, Arkansas Medicaid in cooperation with Title V and Children's Me... more In December 1997, Arkansas Medicaid in cooperation with Title V and Children's Medical Services (CMS) implemented guidelines for the preauthorization of therapy services for Children with Special Health Care Needs (CSHCN). The University of Arkansas for Medical Sciences (UAMS) in partnership with Arkansas Medicaid (MCD), and Chidren's Medical Services (CMS) were given the charge of developing clinical practice guidelines for physical therapy (PT), occupational therapy (OT), and speech/language therapy (SLP) for this population based on primary diagnosis and age appropriateness. This process involved the implementation of a statewide, internet-based, clinical information support network. The objective of this article is to describe KIDSCARE, a clinical information support network, currently under development, for the determination of medical necessity and allocation of therapy services for CSHCN.
The role of the family in the assessment of attention deficit hyperactivity disorder
Clinical Psychology Review, 1995
The family plays an essential and primary role in the assessment of Attention Deficit Hyperactivi... more The family plays an essential and primary role in the assessment of Attention Deficit Hyperactivity Disorder (ADHD) in children. This article seeks to provide the clinician with an understanding of the families of children with ADHD and how the functioning of the family might impact the outcome of assessment. It does so by discussing the role of the family in
Estimates of the Validity and Utility of Unstructured Clinical Observations of Children in the Assessment of ADHD
Clinical Pediatrics, 2005
The purpose of this prospective study was to examine the validity and diagnostic utility of unstr... more The purpose of this prospective study was to examine the validity and diagnostic utility of unstructured clinic observations of attention deficit hyperactivity disorder (ADHD) behaviors in children. Results showed observations to be related to behavioral ratings of parents but not of teachers. The relationship between observations and parent ratings was stronger for hyperactive-impulsive than inattentive behaviors. The level of agreement between observations and classification of ADHD significantly exceeded chance levels only for parent measures of hyperactivity-impulsivity. Only parent measures predicted a diagnosis of ADHD at a rate that was significantly better than chance. Clinic observations were found to have consistently higher positive predictive power than negative predictive power. Clinical implications are discussed.
Seizure Occurrence in Children Diagnosed with ADHD
Clinical Pediatrics, 2001
B oth attention deficit hyperactivity disorder (ADHD) and epilepsy have impor-tant implications f... more B oth attention deficit hyperactivity disorder (ADHD) and epilepsy have impor-tant implications for a child's learning, social, and behavioral development. Children with ADHD have an increased risk for oppositional behavioral disorders, learning disabilities, emo-...
Differentiating Between Seizures and Attention Deficit Hyperactivity Disorder (ADHD) in a Pediatric Population
Clinical Pediatrics, 2002
... Jane Williams, PhD May L. Griebel, MD Gregory B. Sharp, MD Bernadette Lange, MD Tonya Phillip... more ... Jane Williams, PhD May L. Griebel, MD Gregory B. Sharp, MD Bernadette Lange, MD Tonya Phillips, MD Emily DelosReyes, MD Stephen ... diagnostic tests are in-conclusive or when children live in areas without ready access to video-EEG monitoring, the de-pendence on ...
The Annals of Pharmacotherapy, 2002
To determine whether cardiac indices are altered as assessed by 24-hour ambulatory blood pressure... more To determine whether cardiac indices are altered as assessed by 24-hour ambulatory blood pressure monitoring (ABPM) in male children receiving either chronic methylphenidate or dextroamphetamine/levoamphetamine (Adderall) therapy. Boys 7-11 years old who were receiving methylphenidate or Adderall for a minimum of 2 months were asked to participate. Subjects wore ambulatory blood pressure monitors for 24-hour periods both off and on stimulant therapy. Subjects (n = 17; 8 methylphenidate, 9 Adderall) were well matched. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate differed between off and on stimulant therapy (p < 0.05). DBP load calculated from ABPM reference data was increased significantly (9.0% +/- 5.6% on and 4.8% +/- 4.5% off therapy; p < 0.05) while subjects were taking Adderall. There was a trend toward a greater elevation in blood pressure load during awake hours and a more pronounced decrease during the asleep hours for periods on compared with off-stimulant therapy. This trend resulted in significant (p < 0.05) nocturnal dipping on-stimulant phases compared with off-stimulant therapy for both SBP and DBP (Adderall) and SBP (methylphenidate). Two subjects (1 Adderall, 1 methylphenidate) met the criteria to be considered hypertensive based both on mean awake and 24-hour blood pressure load assessments during their on-treatment period. One additional subject receiving Adderall therapy met the criteria to be considered hypertensive based on blood pressure load criteria while off therapy only. Positive correlation coefficients (p < 0.05) were found when comparing stimulant dose (mg/kg) with the percent change of mean SBP, DBP, and heart rate between off and on therapy (r = 0.56, 0.61, and 0.58, respectively). These preliminary data suggest that blood pressure and heart rate appear to be altered in male patients while receiving stimulant therapy for attention-deficit hyperactivity disorder. Blood pressure and heart rate screening and monitoring during stimulant therapy to determine whether alterations become clinically significant is encouraged.
Journal of Autism and Developmental Disorders, 2012
Oxidative stress and abnormal DNA methylation have been implicated in the pathophysiology of auti... more Oxidative stress and abnormal DNA methylation have been implicated in the pathophysiology of autism. We investigated the dynamics of an integrated metabolic pathway essential for cellular antioxidant and methylation capacity in 68 children with autism, 54 age-matched control children and 40 unaffected siblings. The metabolic profile of unaffected siblings differed significantly from case siblings but not from controls. Oxidative protein/DNA damage and DNA hypomethylation (epigenetic alteration) were found in autistic children but not paired siblings or controls. These data indicate that the deficit in antioxidant and methylation capacity is specific for autism and may promote cellular damage and altered epigenetic gene expression. Further, these results suggest a plausible mechanism by which pro-oxidant environmental stressors may modulate genetic predisposition to autism.