Putnam is a fourth-year PhD candidate in the Speech and Hearing Sciences program. Her research involves characterizing what autism looks like in people who are assigned female at birth using language processing, eye tracking, and qualitative methods. She will use the award funds to support the dissemination of her research by supporting her travel costs to conferences.

“I am so honored to be receiving this award, and it feels wonderful to be recognized for my research,” said Putnam. Once she completes her PhD, Putnam’s goals are to pursue postdoctoral training in language processing and other methods of characterizing communication and establish her own research lab at a university.

Kawabata is a PhD candidate in the Occupational Science program and pursues a research focus on the occupation of play for children and youth in a historically Black neighborhood in Hillsborough, NC. She is conducting ethnographic research in this neighborhood that has experienced many immigrant families moving into its affordable housing.

“I am collaborating with a resident-led community watch group to conduct the study,” said Kawabata. “I am interested in describing and exploring how play for youth in this community is shaped through socio-historical elements and how play contributes to community cohesion.”

She plans to use the funds for research dissemination and to present at various conferences. Kawabata aspires to make use of her expertise in community-based research that she has gained in the program, and bridge that experience with the Japanese occupational science community and the rest of the world.

Gangwani is a fourth-year PhD student in the Human Movement Science program, and her research focuses on using multi-modal neuroimaging techniques to develop brain-based measures in individuals with neurological conditions across the lifespan. After completing her PhD, she hopes to secure a postdoctoral position to develop her expertise in neuroscience and neurorehabilitation.

“I’m thrilled and deeply appreciative to have received this award,” said Gangwani. “This recognition motivates me to further my research and academic pursuits, reinforcing my dedication to contributing meaningfully to the field of stroke rehabilitation.” She will use the funds to attend and present for the first time about her dissertation project at the American Society of Neurorehabilitation conference.

Kim is a third-year PhD student in the Division of Speech and Hearing Sciences. She studies aphasia and apraxia of speech, and is interested in discourse-based early differential diagnosis. She has used her funding to attend the Motor Speech Conference in San Diego, where she presented to her peers and colleagues.

“I was so surprised to receive this award – I did not expect to receive it, but at the same time, I was eager to hear back from the committee,” said Kim. “I am so thankful to the committee, my advisors, and myself, too, for persevering with the application.”

Kim’s goal is to better understand acquired neurological communication disorders. She wants to contribute to developing diagnostic methods that are less stressful for people with aphasia yet sensitive to the early differentiation of degenerative diseases.

NIMH R21 grants support the early stages of exploratory and developmental research. According to the NIMH, these studies are considered high-risk but with the potential to lead to breakthroughs and make significant impacts in the area of the research.

“Our team has been working to understand various risk factors for suicidal thoughts and behaviors in autism,” said Harrop. “Suicide is the leading cause of death in autism and a major public health issue.” While there is an increased risk for individuals with autism to think about and die by suicide, it remains an overlooked crisis that the team is studying with hopes to change.

Project Details

Harrop and her team became interested in the grant as it related directly to some of their existing research. “The National Institute of Mental Health announced funding opportunities related to social disconnection and suicide in older adults around the time we started our (Organization for Autism Research) and it seemed too good an opportunity to not apply to it,” said Harrop.

In this fully remote study, the team plans to recruit 65 older adults, including 40 with an autism diagnosis. The participants will be asked to complete a series of surveys about their social connections (in person and online) and community activities and attend a clinical interview on Zoom, which will address topics such as suicidal thoughts and behaviors.

In addition, the participants will wear GPS trackers for a week that will allow the team to record the locations in which they are traveling in the community, their resource utilization, and their time spent away from home. Subsequently, a second Zoom interview with the team will be conducted to discuss their community activities and social connections collected from the GPS data.

“Our goal is to use this mixed methods data to understand how different sources of social disconnection serve as potential risk factors for suicidal thoughts and behaviors in older adults,” said Harrop. “We hope the data will provide actionable areas for which we can begin to develop effective and scalable interventions for this vulnerable population.”

Furthermore, Harrop explains that the study will “examine potential sex and gender differences in social connections as a protective factor for suicidal thoughts and behaviors in older autistic and non-autistic adults.”

Harrop and her team hope the project will expand the body of knowledge related to suicide prevention and intervention by improving their understanding of suicide risk in older adults with autism.

About the Research Team

Harrop is an assistant professor within the Department of Health Sciences’ Office of Research and Scholarship and the ������ TEACCH Autism Program. Throughout her research, she has focused on using various methods to understand the sex differences in individuals with a diagnosis of autism.

Chan is an associate��professor and admissions chair in the Department of Health Sciences’ Division of Clinical Rehabilitation and Mental Health Counseling. Her research interests include utilizing global positioning systems (GPS) and geographic information systems (GIS) to understand and measure community participation and integration, and resource utilization.

Klinger is an associate professor in the Department of Psychiatry and the director of the ������ TEACCH Autism Program. She is a clinical psychologist committed to community-based care and methods to support the implementation of evidence-based practices in community settings. Her current research is focused on identifying and supporting service needs for individuals from young adulthood through aging.

This study compared ACSCs hospitalization patterns and outcomes among autistic children nationally by race/ethnicity and income level. Using secondary data from the US Nationwide Inpatient Sample (NIS), we conducted multivariable regression analyses to determine the potential effect of race and income level on the likelihood of inpatient stays for ACSCs among autistic children after controlling demographic and clinical characteristics.

Our results highlight the existing racial/ethnic and income disparities in preventable hospitalization among underserved children. Racial minority and children from low-income family have poorer primary care experiences and have higher risk of preventable hospitalizations for ACSCs. Inequities of access to health care among racial/ethnic minorities were most notable for autistic children with chronic preventable conditions. Specifically, the burden of asthma hospitalization falls disproportionally on autistic children of Black race. ASD disparities and inequities of access to health care among racial/ethnic groups persist. Some hospitalizations may be avoided through better primary care and chronic disease management such as improving parent and provider communication for adherence to asthma medications.

Clinical and social programs, policies and interventions need to be aimed at ensuring the availability of and accessibility to quality primary care for low-income Hispanic and Black children with ASD and mitigating health inequities associated with potentially avoidable hospitalization.

Contact for more information:
Wanqing Zhang
Research Methodologist
Assistant Professor
3003 Bondurant Hall
CB #7122

Email: wanqing_zhang@med.unc.edu
Office phone:�� (919) 962-4069

Principal Investigators:
Wanqing Zhang, PI
Linda Watson, Co-I
Khalilah Johnson, Co-I

Lead Principal Investigators:��
Wanqing Zhang

Primary Funding Source:
Health Resources and Services Administration (HRSA)

Project Start Date:
September 1, 2021

Project End Date:
August 31, 2023

View the report:

“Autism is diagnosed at a rate of four males to one female, so we know considerably less about the profiles and trajectories of autistic females,” says Harrop. “However, there is a growing consensus that females are underdiagnosed and understudied, potentially due to differences in how autism presents in females. What we do know comes from small, single time-point studies which prevent our understanding of how autistic males and females may differ over time and during different developmental periods.”

Harrop, with University of North Carolina – Chapel Hill collaborators (Psychology and Neuroscience), Heather Hazlett (Psychiatry) and Rebecca Grzadzinski (Psychiatry), will study the developmental trajectories of young autistic females and males, as well as non-autistic peers, using multiple methods within an accelerated longitudinal design.

“Such a design allows us to extend our previous findings to a larger sample and provide a novel way to chart development in harder to reach groups, such as autistic females,” says Harrop.

The project will also collaborate with (Children’s National Hospital) to study how gender impacts development, and with (Children’s Hospital of Philadelphia) to chart the emergence of camouflaging behaviors in autism.

“Autistic youth and adults are more likely to experience gender diversity than non-autistic youth. But no study has charted the early development of gender in autism,” says Harrop. “Additionally, autistic individuals, particularly females, are more likely to employ certain behaviors, such as making eye contact or small talk, to mitigate some of their day-to-day challenges. We know this can have profound downstream effects on mental health.”

Harrop’s project builds on her previous work funded by the Autism Science Foundation and a . She and her team will begin recruitment for the study in early 2022.

“We are incredibly excited to start this research. Our goal for a number of years has been to recruit and follow a large, longitudinal cohort of females through key developmental periods. This is the first stage and we hope to extend our work to non-binary youth in the future. We hope this work can contribute in meaningful ways to the lives of autistic females and their families.”

Clare Harrop, PhD is an Assistant Professor and Translational Research Methodologist within the Department of Allied Health Sciences Office of Research and Scholarship.

Daniel Bauer, PhD is a Professor and Director of the Quantitative Psychology Program and L.L. Thurstone Psychometric Laboratory of the Department of Psychology and Neuroscience.

Heather Hazlett, PhD is an Assistant Professor in the Department of Psychiatry at ������ Hospitals – Chapel Hill.

Rebecca Grzadzinski, PhD is an Assistant Professor in the Department of Psychiatry at the Carolina Institute for Developmental Disabilities.

View Project Poster

Contact for more information:
Wanqing Zhang
Research Methodologist
Assistant Professor
3003 Bondurant Hall
CB #7122

Email: wanqing_zhang@med.unc.edu
Office phone:�� (919) 962-4069

Principal Investigators:
Wanqing Zhang, PhD, (PI)
Paul Chelminski, MD, (Co-I)
Doré LaForett, PhD, (Co-I)
Kelsey Thompson, MS, (RA)

Lead Principal Investigators:
Wanqing Zhang

Primary Funding Source:
Maternal and Child Health Bureau

Secondary Funding:
Health Resources and Services Administration (HRSA)

Project Start Date:
July 1, 2019

Project End Date:
June 30, 2021

Institutions Involved:
Frank Porter Child Development Institute (FPG)

Researchers

• Wanqing Zhang, PI
• Linda Watson, Investigator
• Doré LaForett, Investigator
• Kelsey Thompson, Research Assistant