Drowning is one of the leading causes of death in children and teenagers. Individuals with autism spectrum disorder (ASD) are at increased risk for drowning. Improvements in swim skills have been observed in children with ASD participating in learn-to-swim programs. However, it is unclear if age, co-occurring conditions, and/or the dose of practice influence swim skills in this population. To this end, a secondary data analysis of iCan Swim program data was conducted to determine the efficacy of the 5-day adapted learn-to-swim program for a cohort of children with ASD ages 3–16 years (n = 86). Participant swim level was evaluated at the start and end of the program. Linear mixed-effects regression was used to examine the effects of Time (start/end), Age, Dose of Swim Practice (i.e., total time–time out of the water), and ADHD status on the overall swim level. Participants significantly increased the swim level from the beginning to the end of the program (B = 0.63, 95% CI = 0.52–0.74), and participants with ASD and co-occurring ADHD had greater swim levels regardless of Time than those without ADHD (B = 0.45, 95% CI = 0.05–0.84). Overall, iCan Swim is effective in improving the swim skills of children and teenagers with ASD.

Improving the development of the social, emotional, and physical domains during early childhood impacts the overall trajectory of a child’s well-being. However, researchers often address these independently, leaving a gap for a more integrated approach to promoting development. This study explores the effects of a dual-component intervention on changes in preschool-aged boys’ and girls’ gross motor and social–emotional skills. Preschoolers (N = 475; girls = 220 and boys = 255) ages 3–6 years completed the 9-month dual-component intervention and were randomized into control (n = 148) or intervention (n = 327) groups by classroom. Significant improvements were observed in social skills, locomotor, and total Test of Gross Motor Development-3. Additionally, boys and girls improved at the same rate in ball skills, locomotor, and total Test of Gross Motor Development-3. These results suggest that the dual-component intervention can improve preschoolers’ social skills and motor skills with no differential effects.

As the prevalence of autism spectrum disorder (ASD) increases, there is a growing need to develop physical activity interventions that address the behavioral challenges experienced by individuals with ASD. Physical education teachers have employed behavioral supports that add more structure and adapt the environment for individuals with ASD, which are associated with increased engagement for individuals with ASD during PE. The purpose of this study was to quantify motor engaged behaviors (i.e. motor appropriate (MA)), motor inappropriate (MI), motor supported (MS) during skill practice in 18 individuals with ASD (ages 7-19 years) participating in an adapted tennis program (ACEing Autism) using the Academic Learning Time in Physical Education (ALT-PE) instrument. Overall, the supports provided during the program may have enabled participants with ASD to spend more time in MA and MS than MI. Indeed, the participants spent over 50% of their time in MA during the program.

Down syndrome (DS) is a leading genetic risk factor for Alzheimer's disease (AD). Although prevention and treatment of AD are well documented for those without DS, less is known about individuals with DS. This review evaluates the efficacy of AD and dementia interventions in people with DS. It includes 26 articles with 1417 participants ages 18–69 in the qualitative synthesis and 17 articles with 1118 participants in the meta‐analysis. Four types of interventions demonstrated small‐to‐moderate effects: pharmacological ( n = 19), exercise ( n = 5), environmental ( n  = 1), and cognitive training ( n  = 1). Significant treatment effects were observed across interventions ( t (66) = 4.67, p < 0.0001, d = 0.29, 95% confidence interval [CI]: 0.16–0.40); however, high heterogeneity ( I ² = 93.8% CI = 92.8–94.7) was noted, which was not explained by intervention type or outcome. The meta‐analysis indicates that interventions enhance AD‐related cognitive and behavioral outcomes, emphasizing the need for further research to address heterogeneity. This review was registered with PROSPERO: CRD42024567026. Highlights: This study is the first to comprehensively review both pharmacological and non‐pharmacological interventions for Alzheimer's disease (AD) in individuals with Down syndrome (DS), extending previous reviews by including a meta‐analysis and examining key mediating variables. Donepezil, the most studied pharmacological treatment, showed significant cognitive and behavioral improvements in individuals with DS, especially with longer treatment periods. However, further trials are needed to explore its efficacy in combination with non‐pharmacological interventions. All seven non‐pharmacological studies reported significant improvement, suggesting that even small doses of exercise and cognitive training can be effective and feasible for individuals with DS. Online formats may enhance scalability and reduce barriers to participation. Significant heterogeneity in cognitive assessments across studies highlights the need for standardized, sensitive assessments to enable meaningful comparisons of intervention effects. Additional studies are required to determine the long‐term efficacy of pharmacological interventions like Donepezil and to assess the sustained impact of non‐pharmacological interventions on key AD‐related cognitive domains such as memory, language, and executive function.

Background: The Indiana Complex Care Coordination Collaborative (IC4) is a statewide initiative designed to enhance care for children with medical complexity (CMC) by embedding nurse care coordinators within clinical practices. This study explored clinicians' perspectives on how these coordinators influenced care delivery.Methods: Fourteen clinicians from six participating medical systems completed semi-structured interviews. Discussions focused on the impact of care coordinators on workflow, patient care, clinician workload, and the medical home experience. Transcripts were analyzed using an inductive approach to identify key themes and insights.Results: Clinicians consistently described care coordinators as central to improving communication and access for families, serving as a reliable point of contact, and facilitating smoother interactions with the healthcare system. They noted that care coordinators helped organize patient information, enabling focused and efficient clinical encounters. This support reduced administrative burden and allowed clinicians to prioritize patient needs more effectively. Additionally, care coordinators played a vital role in educating staff, advocating for families, and addressing both medical and non-medical concerns. While clinicians emphasized the value of care coordination, they also highlighted the need for clearer role definitions and adequate training to ensure coordinators are fully integrated and utilized appropriately.Conclusion: Clinicians reported that embedded care coordinators significantly enhanced the quality, efficiency, and responsiveness of care for CMC. Their perspectives underscore the importance of structured, well-supported care coordination to improve clinical practice and patient outcomes.

The Indiana Complex Care Coordination Collaborative (IC4) is a statewide model of care coordination design to enhance the quality of medical care for children with medical complexity (CMC) by training and embedding nurse care coordinators in primary care practices. This study examines the impact of IC4 care coordinators on caregivers' and patients' quality of medical care, access to medical and community resources, care workload, and the quality of life of caregivers and CMC. Caregivers of CMC (n = 13) completed one-hour semi-structured interviews focused on met/unmet needs, quality of medical care, co-developed shared plan of care, caregiver/patient quality of life, caregiver workload, and medical home experience. Using NVIVO, researchers used a codebook to conduct an inductive thematic analysis of the interview transcripts. The thematic analysis was revealed five overarching themes: (1) central role of the care coordinator, (2) proactive and personalized support, (3) care across the lifespan, (4) emotional support, and (5) navigating healthcare systems. Caregivers reported that they considered their care coordinator a trusted health professional who can advocate for them with other health professionals. Families appreciated that the shared plan of care created with the care coordinator can be easily disseminated to other healthcare and service professionals, as well as other family members, and helps the patients and families be seen as individuals, not just as a medical record. Care coordination can address unmet needs and greatly improve the quality of and access to care received by CMCs and their families. Unanimously, caregivers report the substantial instrumental, informational, and emotional support care coordinators (CCs) provide to access medical systems, resources, planning, and reduce patient care workload. Additionally, several caregivers reported substantial social support from the CC. However, several caregivers still reported feelings of loneliness and difficulties engaging with families without CMC.