Overcoming dementia-related stigma is a global challenge, but tools to assess stigma among family caregivers of people living with dementia remain limited. This study examined the validity and reliability of the Japanese version of the Family Stigma Instrument for family caregivers of people living with dementia (J-FAMSI-dementia), originally developed in the UK. A total of 372 informal caregivers aged 18 to 79 years of family members living with dementia completed an internet survey. The J-FAMSI-dementia comprises five subscales (stigma by association; perceived, affective, and behavioral affiliate stigma; and positive aspects of caregiving), developed through forward and backward translations. Confirmatory factor analysis supported an acceptable five-factor model. All subscales showed high internal consistency and moderate to good test-retest reliability. Correlations with dementia attitude, caregiving burden, and depressive symptoms supported construct validity. The J-FAMSI-dementia demonstrated acceptable validity and reliability and may help identify dementia-related stigma among family caregivers.
ObjectiveWhen caring for patients with life-threatening disease, the family caregivers' life and health are affected. This study aimed to culturally adapt and validate the content of the Carer Support Needs Assessment Tool (CSNAT) and to identify support needs in family caregivers of patients receiving home-based palliative care in Chile.MethodsThis cross-sectional study was conducted between May and December 2023 in two Chilean healthcare institutions. It involved three phases: (a) translation/adaptation of the Spanish-CSNAT, (b) cultural adaptation of the CSNAT by an expert committee, and (c) caregivers pretesting CSNAT followed by interviews. Experts and caregivers evaluated the content (clarity and relevance) of the sixteen CSNAT domains. Caregivers reported their support needs and whether CSNAT should include additional needs.ResultsNine experts and thirty-six caregivers participated. The experts found linguistic issues in four domains, which were revised by the CSNAT team-UK. A large proportion of experts (67-100%) and caregivers (90-100%) reported each of the CSNAT domains as clear. The domain with the highest average relevance-score was 'looking after your own health'. Cognitive interviews with caregivers showed high acceptability of CSNAT. 'Knowing what to expect in the future' was the need caregivers most often wished more support for (77%). Emotional support, lack of free time and financial support were identified as needs not covered by CSNAT.ConclusionThe Spanish CSNAT showed good content validity for detecting support needs in family caregivers of patients receiving home-based palliative care in Chile. Therefore, we recommend its use in clinical practice and palliative care research.
Cardiac toxicity from QT-prolonging drugs can precipitate malignant ventricular arrhythmias in susceptible individuals, and family screening may clarify inherited risk. We report a 33-year-old woman with a history of postpartum cardiac arrest treated with a secondary-prevention implantable cardioverter-defibrillator (ICD) who developed an electrical storm after self-administration of a single low dose of amitriptyline (12.5 mg). ICD interrogation documented 176 episodes of ventricular fibrillation requiring repeated shocks, followed by complete battery depletion, hemodynamic collapse, and the need for venoarterial extracorporeal membrane oxygenation and continuous renal replacement therapy. The admission electrocardiogram showed marked QT prolongation (QTc 651 ms), with previously documented prolonged baseline QTc values. Targeted next-generation sequencing identified a novel SCN5A missense variant (NM_000335.5:c.5738G > A) and a rare pathogenic KCNQ1 splice variant (NM_000218.3:c.1032G > C), cascade testing across the family demonstrated variable expressivity among carriers. Given a suspected contribution of late sodium current, a mechanism-based strategy was implemented with mexiletine added to propranolol and overdrive pacing (90 bpm). This case underscores the risk of malignant ventricular arrhythmias after exposure to QT-prolonging agents even at low doses, and supports genotype-informed, mechanism-based therapy to mitigate arrhythmic risk in patients with marked QT prolongation.
The National Medical Commission (NMC) of India introduced Family Adoption Programme (FAP) as a part of curriculum based medical education (CBME) for undergraduate medical students in March 2022. This program was started to provide experiential learning opportunities to undergraduate students towards community-based healthcare. A descriptive cross-sectional study was conducted including undergraduate medical students from all over the country through an online survey. A structured and validated questionnaire was circulated that consisted of both closed and open-ended questions related to perceptions regarding FAP, challenges faced and suggestions for better implementation. Data were collected, responses were analysed and SWOT (Strength, Weakness, Opportunity and Threats) analysis was conducted. Responses were received from 1054 undergraduate medical students from government & private medical colleges across the country. 51.2%, 41.2% and 5.1% participants were from the 1st Professional Year, 2nd Professional Year and 3rd Professional Year respectively. 85% and 87% students agreed/strongly agreed that FAP is helpful to gain an understanding of rural life and to develop a sense of social responsibility respectively. 90% agreed/strongly agreed that FAP is helpful to develop AETCOM skills. Language barrier and resistance offered by families were major challenges. Frequent community visits, training in the local language, provision of benefits to the families and development of a digital database are suggestions for better implementation. Undergraduate medical students are enthusiastic towards the family adoption program and consider it important in the development of social responsibility and AETCOM skills. Future studies are required to include perception of all stakeholders.
Oral and maxillofacial pathology (OP) and oral medicine (OM) are recognized specialties in Brazil and worldwide. Identifying dental students' intentions to pursue these fields and understanding the factors influencing their career choices may provide insights into the future of the specialties. Therefore, this study aimed to determine the intention of Brazilian final-year dental students to pursue the professional career in OP and OM. Final-year undergraduate dental students, from various public and private institutions in Brazil, were invited to voluntarily complete a self-administered and anonymous virtual questionnaire. The questionnaire consisted of 11 questions. The statistical analysis consisted of describing the absolute and relative numbers, and performing analytical statistics using Pearson's chi-squared test for categorical variables. A total of 358 students participated of the study. The majority were female (75.1%), with a mean age of 25.27 years, mainly from public universities (52%). The main careers pursued were restorative dentistry (39.1%), dental implantology (37.7%), prosthodontics (33%), and orofacial harmonization (31.3%). The main reasons for choosing specialization were to stand out in the profession and to perform better in the profession with better clinical outcomes. OM was reported as a career choice by 17% of students and OP by 7.5%. The motivations for such choice were vocation and influence from professors, colleagues, or family members. The results revealed a surprising and concerning finding: interest in the fields of OP and OM, which are fundamental for diagnosing and treating complex conditions of the oral cavity, was relatively low.
As per the National Family Health Surveys (NFHS) rounds four and five, the proportion of women of reproductive age affected by anemia has risen from 53.1% in 2015-16 to 57% in 2019-21. Despite extensive governmental interventions, this upward trend suggests evolving determinants contributing to anemia. Therefore, the present study seeks to examine the sociodemographic, maternal, reproductive, behavioral, and environmental factors linked to anemia among women of reproductive age. A secondary analysis was performed using data from NFHS-5, encompassing 724,115 women aged 15-49 years. The severity of anemia was classified into categories, and binary logistic regression was applied to determine the adjusted odds ratios (aORs) along with their corresponding 95% confidence intervals. Sample weights were calculated, and a complex sampling design was applied to present the results. A high prevalence of anemia, 57% (56.8%-57.3%), was observed among the reproductive age group females in India. Younger age females (<20 years) were significantly more anemic as compared to females of the age groups of 20-35 years [aOR = 0.95 (0.94-0.97)] and >35 years [aOR = 0.94 (0.92-0.96). Having three or more under-five children [aOR: 1.05 (1.01-1.09)], lactation [aOR: 1.17 (1.15-1.20)], and a history of termination of pregnancy [aOR: 1.04 (1.02-1.06)] were the significant factors, and use of modern contraceptive methods was a protective factor [aOR: 0.97 (0.96-0.99)] for anemia. This study shows a higher prevalence of anemia among reproductive-age group females. Addressing these identified risk factors through an innovative targeted approach will better address anemia among Indian women during their reproductive years.
To assess perspectives and institutional support regarding assisted reproductive technologies among female U.S. otolaryngology residents. This cross-sectional survey study examined ACGME-accredited U.S. otolaryngology residency programs from June 2024 to August 2025. A 15-question anonymous REDCap survey was distributed to otolaryngology residents examining demographics, reproductive goals, and program support for assisted reproductive technologies. Of 48 respondents (response rate 6.53%), an overwhelming majority (87.5%) planned first childbirth after age 30, and 83.3% reported delaying pregnancy during residency; while 68.8% expressed interest in oocyte freezing, only 18.8% reported employee-sponsored fertility benefits, and 89.6% received no fertility preservation education. Findings highlight a mismatch between rigorous residency demands and family planning. While avenues exist for preserving fertility, lack of support and education complicate navigating these processes. Expanding benefits, integrating fertility education into residency curricula, and fostering open dialogue may support resident well-being. 3.
Wilson disease (WD) is a hereditary autosomal recessive disorder of copper metabolism, which results from mutations in the ATP7B gene. It is a monogenic disorder characterized by significant clinical heterogeneity in patients with renal, ocular, hepatic, and neurological involvement, complicating its clinical diagnosis. This study involves examination of an Iranian family with a child diagnosed with WD. After various clinical tests, Whole Exome Sequencing (WES) and Sanger sequencing were carried out on the proband to identify the cause of the disease and verify the results. Segregation analysis was also performed. The next step was the study of protein conservation and its alterations after mutation. The WES analysis revealed that the c.1883_1884del [p. His628ArgfsTer126] and c.2145 C > T variations in the ATP7B gene, in compound heterozygous form, were linked to WD in the proband. The analysis also determined that the proband inherited c.1883_1884del [p. His628ArgfsTer126] from his mother's side and c.2145 C > T from his father. A decrease in the amount of translated protein compared to the wild-type leads to the appearance of clinical symptoms in the affected individuals. This study added criteria PP1, PP4 and PS4 to c.1883_1884del [p. His628ArgfsTer126] according to the ACMG guidelines and also supports a potential reclassification of c.2145 C > T variant from variant of uncertain significance (VUS) to likely pathogenic by adding PP4 and PM3. These findings will significantly help specialists in their decision-making about these variants.
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Timely, individually tailored support for family caregivers of cancer patients is stressed, reinforcing the importance of implementing screening tools in clinical practice. This study aims to evaluate the validity and reliability of the Swedish CancerSupportSource-Caregiver among 145 Swedish family caregivers of persons diagnosed with cancer. We evaluated the validity and reliability of the Swedish CancerSupportSource-Caregiver among 145 Swedish family caregivers of persons diagnosed with cancer who responded to the Swedish CancerSupportSource-Caregiver, sociodemographic questions, and the Hospital Anxiety and Depression Scale. Psychometric analyses were performed using descriptive statistics and classical test theory to evaluate data quality, targeting, scaling assumptions, and internal validity. Construct validity was assessed through confirmatory factor analysis; criterion validity through concurrent validity; and reliability through internal consistency. Overall, in the sample, evaluations demonstrated generally satisfactory psychometric properties with respect to data quality, targeting, and scaling assumptions. The hypothesized five-domain model showed an acceptable fit to the data, although there were indices that it could be improved. Item loadings were generally high, supporting the proposed construct structure. Further, assessments of the criterion validity were satisfactory. However, the evaluations of internal validity and internal consistency indicated redundancy, mainly within the emotional well-being domain. The Swedish CancerSupportSource-Caregiver demonstrated preliminary satisfactory abilities to screen for support needs and psychological distress among Swedish family caregivers of persons diagnosed with cancer. Further evaluations in larger samples, using Rasch measurement theory, could provide a deeper understanding of the functioning of items and response options.
Continuity clinics are a cornerstone of family medicine residency. The unpredictable nature of clinic limits the opportunity for formal education during a session. We developed a novel resident-faculty workshop using the 'One Minute Preceptor' model to teach five microskills of precepting. This cross-sectional, observational study evaluated the effectiveness of a single resident-faculty workshop in improving implementation of a systematic method of precepting. We conducted a 45-minute workshop during a quarterly resident and faculty meeting at a large academic family medicine residency. Faculty members and residents completed pre- and 2-month post-assessments measuring change in the five core precepting microskills over time. Independent T-tests were conducted to assess statistical significance between mean scores related to the core microskills of the pre- and post-group. Post-intervention, participants were significantly (p<0.05) more likely to 'get a commitment' from their learner. The remaining four microskills had numerical improvements in mean scores in the post-intervention assessment but did not achieve statistical significance. This workshop led to improvement in incorporating one of the five microskills of precepting and showed that a brief educational session can be effective as an educational intervention for outpatient precepting.
Information regarding risk factors among service member families for different child maltreatment types is needed to improve prevention efforts. To identify factors associated with first occurrences of 4 child maltreatment types and examine child age-related changes in risk for each type among active duty service member families. This population-based retrospective cohort study used data from the Child Maltreatment in Military Families Life Course Study on active duty service member families with a first occurrence of child maltreatment in fiscal years 2009 through 2018 and a representative sample of active duty families without child maltreatment incidents. Data were analyzed from August 2023 to February 2026. One or more parents serving as an active duty service member. First documented occurrences of neglect, physical abuse, emotional abuse, and sexual abuse, identified using Family Advocacy Program data. Associations between sociodemographic, family, and military-related characteristics and first occurrences of maltreatment types were examined in univariable and multivariable logistic regressions. The study included 618 101 active duty service member families (28 684 [4.64%] with a first occurrence of child maltreatment and 589 417 [95.36%] without child maltreatment incidents), consisting of 1 070 510 family-months (FM); the total weighted sample was 65 142 809 FM (59 031 293 male service member FM [90.62%]; mean [SD] age, 32.74 [6.97] years). Crude rates of child maltreatment were highest for child neglect (22.16 per 100 000 FM) followed by physical abuse (10.97 per 100 000 FM), emotional abuse (4.23 per 100 000 FM), and sexual abuse (2.66 per 100 000 FM). Factors associated with higher odds of all child maltreatment types in multivariable models were female service member families (eg, sexual abuse: odds ratio [OR], 1.39 [95% CI, 1.18-1.64]; physical abuse: OR, 1.82 [95% CI, 1.70-1.95]), early parenting (age <21 years) (eg, neglect: OR, 1.32 [95% CI, 1.22-1.41]; sexual abuse: OR, 2.12 [95% CI, 1.75-2.56]), larger number of dependent children (≥3) (eg, emotional abuse: OR, 1.63 [95% CI, 1.48-1.79]; sexual abuse: OR, 2.32 [95% CI, 2.06-2.61]), and never-deployed status (eg, sexual abuse: OR, 1.90 [95% CI, 1.55-2.32]; emotional abuse: OR, 3.76 [95% CI, 3.09-4.57]). Risk rates peaked at 3 months of age for neglect (48.61 per 100 000 FM) and physical abuse (25.49 per 100 000 FM). Risk of emotional and sexual abuse peaked in middle childhood (age 5-12 years) and adolescence but was generally lower (<6 per 100 000 FM) than risk of other child maltreatment types across all ages. In this cohort study, families with female service members, never-deployed service members, 3 or more children, and young parents had higher risk of child maltreatment. Dynamic prevention approaches appear to be needed to address evolving risk factors across the family life course.
Loeys-Dietz syndrome (LDS) is a heritable aortopathy characterized by variable cardiovascular involvement, including aortic aneurysms, dissections, and congenital cardiac anomalies. Marked intrafamilial variability is a well-recognized feature, underscoring the importance of systematic assessment of at-risk relatives. We report a family in which the index patient presented with an early ventricular septal defect and progressive aortic root dilation requiring valve-sparing surgery. MRI-based family screening identified four additional affected relatives, demonstrating a broad clinical range from asymptomatic aortic dilation to advanced disease necessitating intervention. This case highlights the marked variability in disease expression within a single family affected by LDS and emphasizes the importance of comprehensive genetic evaluation combined with structured MRI surveillance. Such an approach enables early detection of vascular involvement and supports timely management to prevent severe complications.
The use of restorative practices may be an alternative approach to responding to patients and families harmed by medical racism. Little research has explored its implementation in health care settings or the perspectives of residents and fellows (ie, medical learners) regarding its use in academic clinical settings. To elicit perspectives from medical learners on using restorative practices to address patient and family concerns about racism and other identity-based harms in the health care context. This qualitative study consisted of one-on-one semistructured interviews with residents and fellows between May and July 2024. Participants were invited from 76 adult and pediatric training programs affiliated with the University of Washington. The interview guide was developed by the study team, and interviews were conducted via videoconferencing and lasted approximately 30 minutes. Each participant received a $50 gift card as compensation. Medical learners' perspectives and concerns about implementing restorative practices to address racism in health care settings. Thematic analysis was used to identify these perspectives. Interviews were conducted until thematic saturation was reached. A total of 20 medical learners were interviewed. These participants had a mean (SD) age of 32.3 (3.2) years; 13 (65%) were women and 8 (40%) identified as Asian, 4 (20%) as Black, and 8 (40%) as White individuals. Eight participants (40%) had heard of restorative practices, mostly in the criminal justice and educational settings; 5 (25%) were confident in explaining what restorative practices entailed; and 2 (10%) had participated in restorative circles. In general, medical learners were supportive of using restorative practices to address medical racism and other harms experienced by patients and families. However, medical learners identified important concerns regarding preparation for this work (prework and intention setting), burden of participation (time barriers and personal and professional risks), and goals and outcomes (patient and family willingness, goals identification, and healing and harm mitigation). This qualitative study found that medical learners were open to working with patients and families using restorative practices to address medical racism and other identity-based harms; these participants also identified additional concerns regarding implementation such as preparation, barriers and risks, and meaningful goals and outcomes. Future studies should investigate potential solutions to these concerns as well as include perspectives from patients and families to support evidence-based implementation.
The genus Ferula is an important medicinal group within the Apiaceae family, valued globally for its health and culinary uses. Recently, it has gained significant attention because of its cultivation and use to meet growing demands for food and medicine. However, in the Xinjiang production region, farmers often cultivate multiple Ferula species together. In the market, leaves from different species are frequently bundled and sold, leading to inconsistent product quality. This issue greatly reduces the economic value of Ferula as a food resource and affects the efficacy and safety of its clinical applications. Correctly identifying species is essential for the sustainable use and conservation of these plants. Traditional methods mainly rely on floral and fruit traits, but the monocarpic or polycarpic nature of these plants makes species identification difficult, especially since flowering or fruiting specimens are hard to obtain in cultivated conditions. In this study, leaf samples from 30 Ferula specimens collected from ten cultivated locations in Xinjiang were analyzed using phylogenetic methods and ultraperformance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS) to provide insight for species identification and discrimination. Phylogenomic analysis based on the complete plastome was used to clarify relationships among species. The plastome super-barcoding results showed that cultivated Ferula species clustered into three distinct clades: F. sinkiangensis, F. teterrima, and F. fukanensis. Untargeted metabolomic profiling detected 7,169 metabolites, and multivariate analyses (PCA, PLS-DA and HCA) revealed clear chemotaxonomic separation among the three species, with clustering patterns consistent with the phylogenetic tree. Our findings demonstrate that the integration of plastome super-barcoding with metabolomic fingerprinting offers a robust strategy to species discrimination in cultivated Ferula. This combined approach provides complementary chemotaxonomic evidence for differentiating species, with direct implications for ensuring appropriate use in distinct culinary, medicinal, and pharmaceutical applications.
Exercise is widely recommended for postoperative breast cancer patients due to its benefits for functional recovery and symptom management. However, real-world participation and long-term adherence remain consistently low. Existing research has largely focused on participation rates or perceived barriers, offering limited insight into the behavioral mechanisms that govern how exercise is initiated and sustained over time, particularly within specific cultural contexts. To explore the mechanisms underlying the initiation and maintenance of postoperative exercise behaviors among breast cancer patients, with particular attention to the interaction among behavioral capability, motivation, and cues across different stages of recovery. A qualitative study informed by grounded theory was conducted. Fifteen patients (n = 15) who had undergone unilateral mastectomy were purposively recruited from a tertiary hospital in Foshan, China. Semi-structured, in-depth interviews were carried out and analyzed using open, axial, and selective coding procedures. Postoperative exercise behavior was shaped by the dynamic interaction of three interrelated domains: capability, motivation, and cues. Capability-encompassing physical condition, exercise-related knowledge, and self-regulatory skills-functioned as a threshold condition for behavior initiation. Notably, the capability threshold evolved across the disease trajectory: in the early postoperative phase, it was primarily constrained by acute physical symptoms such as pain and limited mobility, whereas in the long-term recovery phase, it increasingly depended on patients' self-regulatory capacity and ability to integrate exercise into daily life.Motivation acted as a fluctuating driver influenced by perceived benefits, emotional responses, and external support. Cues, including professional guidance and family reminders, functioned as both behavioral triggers and a key maintenance mechanism. In the absence of sustained cues, behavioral discontinuity frequently occurred, even among patients with adequate motivation and capability.Cultural beliefs regarding rest and activity, rooted in the Chinese context, influenced patients' perceptions of exercise safety and timing, thereby shaping motivation and responsiveness to cues. Postoperative exercise behavior among breast cancer patients follows a staged mechanism characterized by capability-dependent initiation, motivation-driven fluctuation, and cue-dependent maintenance. These findings highlight the need for nurse-led, continuous, and context-sensitive interventions, rather than one-time education, to support long-term exercise adherence, particularly in cultural contexts where beliefs about rest and activity may shape patients' exercise behaviors. Nursing interventions should move beyond information delivery and adopt a system-based behavioral support approach that strengthens exercise capability, by incorporating structured exercise prescriptions, continuous nurse-led follow-up, digital reminder systems, and family-supported cueing strategies into routine care.
Antenatal care (ANC) knowledge, birth preparedness and complication readiness (BPCR) improve timely maternal and neonatal care, reducing labor delays and complications. In Gujarat, despite improved health indicators, awareness of pregnancy danger signs is crucial for further reducing maternal mortality. The study objective was to assess pregnant women's knowledge of ANC, BPCR, and to analyze socio-demographic factors associated with the BPCR index. A cross-sectional study (August 2023 to July 2024) surveyed 380 pregnant women from urban and rural antenatal clinics affiliated with a tertiary care hospital. Data were collected through interviews using a validated local-language questionnaire. BPCR was assessed using eight indicators from the Johns Hopkins Program for International Education in Gynaecology and Obstetrics (JHPIEGO) maternal and neonatal health program book. Bivariate and multivariate logistic regression estimated odds ratios, with significance set at a 95% confidence interval, P value < 0.05. Among 380 pregnant women surveyed, 63.7% were well prepared for birth and complications, meeting at least (≥7/8) BPCR indicators, and 54.2% had good ANC knowledge (≥6/8). Socio-demographic factors significantly associated with BPCR outcomes (P value < 0.05) included residence, age, caste, education, occupation, socioeconomic status (SES), family size, and age at marriage and first pregnancy. Notably, unemployed women (aOR: 2.4), illiterate women (aOR: 2.3), illiterate husbands/heads of family (aOR: 3.2), and less ANC knowledge (aOR: 2.1) were strongly linked to BPCR outcomes. Socio-demographic factors like education, occupation, and knowledge during ANC significantly impact BPCR outcomes, and improving these can enhance practices and outcomes for mothers and newborns.
Lymphatic filariasis (LF) remains a significant public health challenge in many tropical regions where the disease is endemic. In Malaysia, LF is found in small pockets across the country. Asymptomatic carriers play a critical role in transmission but are often undetected. This report details an investigation of an asymptomatic filariasis reported by local health authorities involving an 83-year-old female patient residing in the Bako area, Sarawak. Despite being immobile due to a stroke, routine screening identified an infection with Brugia malayi through microscopy and a rapid diagnostic test. Interestingly, the patient exhibited no acute or chronic symptoms typically associated with filariasis. Contact tracing among her family members revealed that her son was also infected. Both patients received treatment with diethylcarbamazine (DEC) at a dosage of 6 mg/kg, along with albendazole 400 mg and ivermectin 12 mg. Preventive measures included health education, entomological studies, and the implementation of a 'Test & Treat Filariasis' program in the village. By documenting both the index case and a secondary asymptomatic case within the same household, the study provides a strong example of how routine screening and contact tracing can identify hidden sources of infection. This adds significant value to LF elimination strategies and emphasizes the importance of community-level surveillance programs. Coordinated efforts by health authorities, including contact tracing, environmental assessments, and targeted treatment, are essential for controlling the spread of LF and safeguarding public health.
Fetal alcohol spectrum disorder (FASD) is a neurodevelopmental disorder (NDD) that can be associated with adverse developmental outcomes. Given that the Canadian FASD diagnostic guidelines were updated in 2016, we aimed to determine changes to kindergarten FASD prevalence as well as the association of FASD with home problems and early intervention compared to autism spectrum disorder (ASD) and other conditions with neurodevelopmental origins (NDO) in the 2010-2015 period versus 2016-2020. Kindergarten teachers reported the medical diagnoses, any home problems, and early intervention attendance for each of their students. Teacher-reported FASD prevalence in kindergarten decreased from 2010-2015 to 2016-2020. In comparison with children with ASD, children with FASD and children with NDO conditions had greater odds of experiencing home problems. Children with FASD and children with NDO conditions were less likely to receive early intervention compared to those with ASD. Diagnosis and family-centred supports should be made accessible to children before school entry.