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Biomedical subjects

D Sauvage

Publications and source records attributed to D Sauvage.

At least 19 recordsLinked to original sources

Autism and genetics: clinical approach and association study with two markers of HRAS gene.

Twin studies and familial aggregation studies indicate that genetic factors could play a role in infantile autism. In an earlier study, we identified a possible positive association between autism and a c-Harvey-ras (HRAS) oncogene marker at the 3' end of the coding region. In an attempt to confirm this finding, we studied a larger population, well-characterized clinically and genetically. We report a positive association between autism and two HRAS markers, the 3' marker used in the initial study and an additional marker in exon 1.

Adolescent

Disorders of regulation of cognitive activity in autistic children.

Infantile autism is a pervasive developmental disorder characterized by disturbances concerning not only the areas of socialization and communication ("aloneness") but also the ability to modify and change behavior ("need for sameness"). In most recent studies, various abnormal and deviant cognitive activities, such as the ability to regulate one's behavior, were considered as accounting for these signs. In this report, we examined the regulation of cognitive activity, from a developmental perspective in comparing autistic with mentally retarded children matched in a pairwise manner by global, verbal, and nonverbal developmental ages. All children were tested with tasks adapted from the Object Permanence Test which corresponds to Piaget's sensorimotor development Stages IV to VI. Results showed that autistic children had a pervasive difficulty in maintenance set, made more perseverative errors when the abstraction degree of task was higher, and were more variable in their behavioral strategies. Discussion is focused on the interests and limits of these tasks for the examination of regulation activity from diagnostic and developmental perspectives. Finally, interpretations about recent neuropsychological and neurophysiological works, and additional interdisciplinary studies are suggested.

Attention

Validity and reliability of the infant behavioral summarized evaluation (IBSE): a rating scale for the assessment of young children with autism and developmental disorders.

The Infant Behavioral Summarized Evaluation (IBSE) is a rating scale adapted from the Behavioral Summarized Evaluation (BSE) and specifically related to the assessment of behaviors of young children having autistic disorders. Content validity and reliability studies described in the paper were made from behavior ratings of videotapes for 89 children aged from 6 to 48 months. Results show a significant group of 19 items including some characteristic early autistic behaviors (communicative and social abnormalities) and some that are less commonly described in the syndrome (attentional, perceptive, and adaptive disorders). The value of the use of this scale for clinicians and professionals involved in behavioral evaluations and treatment of young children with developmental disorders and the necessity for further psychometric investigations are discussed.

Autistic Disorder

Early symptoms in autism from family home movies. Evaluation and comparison between 1st and 2nd year of life using I.B.S.E. scale.

The analysis of 11 home movies taken by parents before the recognition of autistic or atypical disorders of their own child has confirmed the major value of this method for describing early pathological signs. Symptomatology analysis has revealed anomalies of eye contact, a deficiency and variability of emotional expression, a defect of attention and initiation of communication, as well as motor abnormalities. The comparison of the frequency of abnormal behaviour, assessed with a rating scale among three groups of children (autistic, pervasive developmental disorders and normal) revealed behavioural differences as a function of early age and diagnosis, which concern not only social and communicative behaviours, but those of emotion and attention as well. The limits and interest of this methodological approach are discussed and the possibilities of subsequently using these documents in a more complete method, such as blind examination and scoring by uninformed investigators, are suggested.

Autistic Disorder

Autism and family home movies: preliminary findings.

Preliminary analyses of 12 home movies taken by parents before the recognition of autistic disorders of their own child confirm the major value of this method for describing early signs: anomalies of eye contact, deficient variability of emotional expression, defect of attention and initiation of communication, motor abnormalities, etc. The possibilities of subsequently using these documents in a research context are described: behavior assignment with a rating scale, comparative analysis with movies of normal children, blind examination, and scoring by investigators not informed of the diagnosis.

Activities of Daily Living

The Behavioral Summarized Evaluation: validity and reliability of a scale for the assessment of autistic behaviors.

The Behavioral Summarized Evaluation (BSE), is a 20-item paper-and-pencil rating scale specifically designed for the measurement of behavioral parameters which could be related to biological data in autistic children involved in educational programs, neurophysiological studies, and therapeutic trials. The development of the scale, the validity, and reliability studies are presented in this paper. The results suggest that the BSE is an acceptable tool for the assessment of autistic behaviors, easy to handle, and accessible to both professionals and paraprofessionals of the medico-educative staff. It is a useful addition to the bioclinical researcher's evaluation battery for bioclinical and therapeutic studies. However, more work is suggested to further investigate the psychometric properties of this behavior assessment instrument.

Adolescent

[Autism in infants and young children. The value of early diagnosis].

Clinical studies of early symptoms are among the most significant advances achieved during recent years in the field of autism. The first descriptions of early symptoms were retrospective and lacked precision. Autistic children are now being seen increasingly early and new insight is being gained into the initial manifestations and differences in clinical patterns. Similarly, differential diagnosis problems (borderline forms) are changing as clinicians evaluate children at younger ages. Although a definitive diagnosis is neither possible nor even desirable before the age of 18 to 24 months, detailed clinical data should be collected early. This data forms the basis for differential diagnosis and will be needed later for differentiating various clinical patterns of developmental disorders, establishing a prognosis, and monitoring therapeutic effects. In prospective longitudinal studies of autistic children, comparison of recent observations with detailed early data is essential. Early initial evaluation includes videotape recordings, assessment of cognitive functions and communication skills, and use of a scale for autistic symptoms. Using the results of evaluations of very young children, a specific semiology (communication disorders) can be developed. Several symptoms probably denote neurophysiologic and/or perceptive disorders. Primary symptoms are now being better distinguished from secondary anomalies (behavior disorders) that may be avoidable or treatable.

Age Factors

[A psychiatric consultation service at a pediatric hospital. Definitions, nomenclature, perspectives].

A psychiatric consultation service has been implanted for the last 15 years at the Children's Hospital of Tours. It co-ordinates pediatric psychiatric activities on the various wards of this large pediatric center (200 beds). All pediatric psychiatry personnel belong to this autonomous unit which plans their work: clinical care and liaisons, teaching and research activities. This unit manages 1,000 cases a year: 20% of children are aged 0 to 2 years, 40% are under 5 years of age. This type of structure in a university pediatric hospital fosters considerably an early diagnosis and the prompt triaging of children to the services available in their home districts for appropriate care. Furthermore, it facilitates a comprehensive approach with appropriate integration of the somatic and of the psychodynamic dimensions of the child. This type of implantation constitutes a significant step forward in the field. However, its professional activities are handicapped because of the discrepancy between resources made available to psychiatry and pediatrics due to the failure to take into account the type of interventions required of the pediatric psychiatrist. In the hope of remedying these problems of evaluating the services distributed by psychiatry to young children hospitalized in clinical units, we present a specific nomenclature, elaborated after several years of experience. It classifies services in four large categories: Consultation and liaison in in-patient care units; chronic care carried out on a part time basis; admissions to the Pediatric Psychiatry Unit in beds belonging to various pediatric services; complete workups in day care beds.

Adolescent

The presence or absence of certain behaviors associated with infantile autism in severely retarded autistic and nonautistic retarded children and very young normal children.

The modified Behavior Observation Scale adapted from Freeman et al. was used to compare normal, retarded, and autistic children with very low developmental ages and to determine the types of behavior that could differentiate these three diagnostic categories of children. Examination of the data revealed that there was much more overlap between autistic and retarded children than between autistic and normal children. However, a behavioral pattern of autism could be delineated and very retarded autistic children could be distinguished from the nonautistic retarded children. The autistic behavioral pattern included subclusters of symptoms that might be interpreted as disturbances of sensory modulation and motility.

Age Factors

Comparison of clinical diagnoses and Rimland E2 scores in severely disturbed children.

The Rimland E2 questionnaire was applied to three groups of children for whom clinical diagnoses of Infantile Autism, Autism with Associated Symptoms, and Mental Retardation had been made, as well as to normal controls. The results confirm that the Rimland scale is accurate in differentiating autistic from nonautistic children. But the scale does not appear to permit clear differentiation of infantile autism from autism with associated symptoms, and the more typical autistic children (diagnosed as Kanner's EIA) did not all yield high scores. Several possible explanations for this fact are put forward.

Adolescent