Introduction: Research clearly documents the increased risk of silent and overt strokes in pediatric patients with sickle cell disease (SCD), as well as the associated neurocognitive deficits in domains such as working memory (WM) and attention regulation. However, less research has examined the effects of biomarkers of SCD severity, such as cerebral blood flow velocity (CBFV), hemoglobin, and blood pressure, on neurocognitive functioning. This investigation aimed to explore the utility of using biomarkers to predict caregiver-reported neurocognitive and behavioral functioning in pediatric SCD. Methods: Fifty-nine children with SCD ages 7-16 (M = 10.44, SD = 2.87, 42% male) enrolled in a larger study of the feasibility and efficacy of a computerized cognitive training program. As part of this study, a primary caregiver completed the Behavior Rating Inventory of Executive Function (BRIEF) and Conners-3, both caregiver-reported measures of behavioral, attentional, and emotional functioning in children and adolescents. Scores on the BRIEF and Conners-3 are both represented with T scores, where higher scores reflect greater problems. Complete blood count (CBC) and vital signs were extracted from patients' medical charts if results had been documented within 45 days of date caregivers completed the BRIEF and Conners-3. Transcranial Doppler (TCD) ultrasonography results were extracted if a TCD had been performed within 12 months of the testing date. Results: Mean hemoglobin was 9.05 (SD = 1.33), mean hematocrit was 25.84 (SD = 3.71), mean systolic blood pressure was 107.43 (SD = 8.89), and mean diastolic blood pressure was 63.69 (SD = 9.49). TCD results revealed a mean right middle cerebral artery (MCA) CBFV of 206.00 (SD = 21.30), left MCA CBFV of 127.84 (SD = 22.40), right distal cerebral artery (DiCA) CBFV of 86.44 (SD = 23.00), and left DiCA CBFV of100.45 (SD = 27.28). Bivariate Pearson correlations and linear regression analyses were conducted to examine the relationships between biomarkers (e.g., CBFV, blood pressure, CBC results) and caregiver-reported neurocognitive and behavioral functioning. Modest correlations were observed between CBC results (e.g., hemoglobin, hematocrit) and caregiver-rated cognitive and behavioral outcomes; though, these relationships were no longer significant after controlling for age and gender in subsequent regression analyses. However, higher left DiCA velocities significantly predicted more problems on the BRIEF Working Memory and Initiate subdomains (R2 = .569, b = 0.442, p < .001; R2 = .746, b = .466, p < .001, respectively). Additionally, higher left DiCA velocities significantly predicted more caregiver-rated problems on the BRIEF Organization of Materials and Plan/Organize scales (R2= .447, b = 0.191, p = .049; R2 = .377, b = 0.372, p = .00), respectively. TCD and blood pressure results also significantly predicted scores on the caregiver-reported Connors-3 Executive Functioning subscale, with higher left DiCA (R2 = .432, b = 0.446, p = .001) and systolic BP (R2 = .196, b = 0.859,p =.003) predicting more problems with executive functioning. Conclusion: Certain biomarkers of SCD severity appear to have a detectable and direct influence on neurocognitive and behavioral functioning in pediatric SCD. TCD results, specifically left DiCA CBFV, and systolic blood pressure significantly predicted scores on the BRIEF and Conners-3, two caregiver-reported measures of neurocognitive and behavioral functioning. More specifically, higher CBFV and systolic blood pressure were predictive of more caregiver-rated problems with working memory, executive functioning, and organizational skills. These cognitive and behavioral domains are of particular importance in children, who depend on such skills to learn and succeed academically. Progressive disease-related neurocognitive deficits may contribute to long-term difficulties in academic achievement, social functioning, and vocational attainment. Biomarkers of SCD severity, such as CBFV and blood pressure, may be useful indicators of worsening neurocognitive status and signal the need for preventative care to protect neurological integrity and preserve quality of life in pediatric patients with SCD. Disclosures No relevant conflicts of interest to declare.

The purpose of this investigation was to examine communication skill use and related characteristics, as well as factors associated with problematic communication during conferences, in parents and teachers of children on the autism spectrum (AS). Participants were 36 parent-teacher dyads who completed questionnaires on communication, defined within the Listen, Educate, Assess, Partners, Support (LEAPS) Model, as well as measures on problem-solving and relationship quality. Parents reported more frequent use of LEAPSdefined skills than teachers, as well as a more positive view of problem-solving and relationship quality. Both parents and teachers reported similar levels of problematic communication. Problematic communication was inversely associated with problem-solving and relationship quality for parents. For teachers, problematic communication was inversely related to skill use and relationship quality. Communication during parent-teacher conferences may be improved through LEAPS-based communication training for both teachers and parents. This training may diminish problematic communication and align cross-setting intervention practices, and subsequently optimize outcomes for children on the AS.

Introduction: Broad neurocognitive deficits have been documented in children with sickle cell disease (SCD), even in the absence of stroke. These deficits pose significant consequences, as lower cognitive abilities are associated with lower academic achievement. However, there has been limited research examining the relationship between neurocognitive functioning and socioeconomic status (SES) in youth with SCD. Given that children with SCD experience socioeconomic disadvantage at relatively high rates, SES has been posited as one explanation for the high prevalence of neurocognitive issues in SCD; particularly in the case of patients without stroke or those with less severe phenotypes. In order to better understand the role of SES, we sought to evaluate the effects of multiple distinct measures of SES on neurocognitive outcomes in pediatric SCD. Methods: Fifty-nine children with SCD ages 7-16 (M = 10.44, SD = 2.87; 42% male) enrolled in a larger study of the feasibility and efficacy of a computerized cognitive training program. Primary caregivers reported demographic information, including the child's age, gender, and ethnicity, and rated their child's executive functioning difficulties on the Behavior Rating Inventory of Executive Function (BRIEF). Scores on the BRIEF are represented as T scores, where higher scores reflect more problems. Caregivers also reported on multiple measures of SES, including the participant's health insurance type, whether the participant received free-or-reduced lunch at school, and rated the adequacy of household resources (Family Resource Scale; FRS) and their perceived community and national social status (The MacArthur Scale of Subjective Social Status). Children and adolescents completed the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V). Results: Multiple regression analyses were performed to examine the relationship between SES measures and performance-based and caregiver-reported neurocognitive and behavioral functioning. Controlling for age and gender, having public health insurance significantly predicted lower Full Scale IQs on the WISC-V (R2 = .158, b = -8.609, p = .021), as well as greater impairments on the BRIEF Working Memory (R2 = .219, b = -9.556, p = .014), Organization of Materials (R2 = .166, b = -7.498, p = .011), and Monitor (R2 = .137, b = -6.872, p = .038) subscales. Whereas, having private health insurance significantly predicted higher Full Scale IQs (R2 = .187, b = 10.376, p = 0.007) and fewer problems on the BRIEF Working Memory (R2 = .101, b = 7.868, p = .046), Organization of Materials (R2 = 0.209, b = 9.103, p = .003), and Monitor (R2 = .163, b = 8.231, p = .018) subscales. Additionally, receiving free-or-reduced lunch significantly predicted lower scores on a WISC-V task measuring processing speed (R2 = .316, b = -1.976, p = .006) and a composite indicator of processing speed (R2 = .226, b = -9.849, p = .011). In contrast to hypotheses, higher perceived social status within families' communities on the MacArthur Scale of Subjective Social Status was predictive of lower Full Scale IQs (R2 = .089, b = 1.646, p = .049) and higher perceived social status using the United States as a reference predicted greater impairments on the Plan/Organize (R2 = .169, b = 2.287 p = .011) and Initiate subscales of the BRIEF (R2 = .134, b = 1.839, p = .024). Conclusions: It is feasible to measure SES in multiple ways in clinical trials. In our study, SES significantly predicted performance-based and parent-reported neurocognitive functioning; however, each measure of SES appeared to account for a unique component of SES and demonstrated unique associations with neurocognitive outcomes. Public insurance was a significant predictor of more caregiver-rated problems with children's working memory, organizational skills, and executive functioning. Children who qualified for free-or reduced lunch also scored significantly lower on processing speed tasks. Findings support the hypothesis that SES plays an important role in determining neurocognitive and behavioral outcomes and highlights the value of conceptualizing and assessing SES as a multidimensional construct. Researchers and clinicians should routinely assess SES using various measures to enhance detection of neurocognitive difficulties and assist in crafting tailored interventions to mitigate negative consequences of low SES in children with SCD. Disclosures No relevant conflicts of interest to declare.