Behavior assessment of the syndrome of autism: behavior observation system.
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Biomedical subjects
Publications and source records attributed to B J Freeman.
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Fenfluramine was administered to 14 outpatient children with the syndrome of autism to determine whether previously produced decreases in blood serotonin concentrations and clinical improvements could be reinstituted. A double-blind medication-placebo crossover design was used. Each patient received fenfluramine 1.5 mg/kg daily (0.75 mg/kg twice daily) for 8 months, followed by placebo for 2 months. Blood serotonin levels promptly fell approximately 49% regardless of baseline levels. Clinical improvement returned, and on some scales gains after 8 months exceeded those noted after only 4 months of treatment. Significant correlations emerged among the amount of clinical response, initially high verbal IQs, and low blood serotonin concentrations. Compliance was excellent, and no clinically relevant side effects or weight changes occurred. It appears that fenfluramine is effective in ameliorating specific symptoms in certain autistic patients. The extent and mechanism of its action remain to be discovered.
Groups of autistic and mentally retarded children were compared for the degree of stimulus overselectivity manifested during test probes after discrimination learning. Results demonstrated that stimulus overselectivity was a function of diagnostic category when groups were equated for performance IQ and mental age. Procedures used to obtain IQ as well as discrimination learning rate were also shown to be equivalent. Pulse rate response suggested that the test probes may be assessing performance during the early trials of a transfer problem for both groups of children. Implications for 'one-look' models of discrimination learning were discussed.
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The incidence of infertility and two or more spontaneous abortions was significantly increased in the parents, compared to that reported for the general population, in this pilot survey of 61 patients evaluated for major childhood psychoses. In addition, 18% of our patients had a history of early gestational exposure to progesterone/estrogen compounds (9 patients) and to cortisone (2 patients). This frequency of gestational hormoné exposure was significantly increased over that in normal infants from three published surveys. However, in 5 of the 11 patients with gestational hormonal exposure, the medication was prescribed because of prior parental reproductive problems or bleeding during the current pregnancy. Therefore, it cannot be concluded that the gestational hormonal exposure was causally related to the psychoses present in these patients. In order to obtain more conclusive data, there will need to be continued monitoring of parental reproductive histories and gestational environmental exposures in autistic and schizophrenic children.
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The authors are developing the Behavior Observation Scale to objectively differentiate autistic, normal, and mentally retarded children aged 30--60 months. They describe operational definitions and procedures and report data on the frequency of selected behaviors among 114 children. Prior studies have revealed that to assess the clinical significance of behaviors in autistic children, both frequency of occurrence per subject and the number of children exhibiting the behaviors must be considered concurrently. This study confirms the hypothesis that it is critical to consider the IQ of the child when assessing the clinical significance of individual behaviors and groups of behaviors.
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The language of children with autism and other developmental disabilities was examined systematically according to a set of objectively defined linguistic parameters. These criteria were drawn from clinical observations reported in the literature and from developmental norms of language acquisition. Data analysis identified sets of parameters that were correlated with psychiatrists' clinical diagnoses but failed to isolate individual parameters (such as echolalia or noncommunicativeness) that have been suggested to be pathonomic.
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Two groups of three autistic children, equated for chronological age but differing in IQ and performance MA, were observed for 20-minute sessions. Total duration of time subjects engaged in stereotyped behavior was recorded for each minute. During minutes 6--15, subjects were provided with either minimal or high environmental stimulation. High environmental stimulation was found to increase the mean duration of time the low-IQ group engaged in stereotyped behavior but to decrease the duration for the high-IQ group. The theoretical implications are discussed.
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As a result of their unique relationship with families, pediatricians are often faced with the difficult task of counseling the parents of a mentally retarded child. For this reason it is important that he understand the nature of the tools used to evaluate the retarded. Since the IQ test is still the most commonly used tool to assess presence or absence of retardation, this paper has briefly reviewed the concepts of intelligence, the IQ, and their interrelationships and their usefulness when evaluating the mentally retarded child.
The purpose of the present experiment was to examine the reinforcing effects of repetitive vestibular stimulation. While both autistic and retarded children would push a button for vestibular stimulation, frequency of stimulation was an important parameter for autistics but not for retardates. These results were interpreted as evidence for central rather than peripheral locus of control of motility disturbances in autistic children.