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Biomedical subjects

F R Volkmar

Publications and source records attributed to F R Volkmar.

At least 19 recordsLinked to original sources
PubMed1996

Asperger's syndrome.

This Grand Rounds is concerned with the classification of Asperger's syndrome and its continuity/discontinuity with autism. Information on a 15-year-old with the condition is presented as are data on other family members. The proband exhibited a longstanding pattern of marked deficits in social interaction, motor awkwardness, and unusual, circumscribed interest consistent with a diagnosis of Asperger's syndrome. Both the proband and his father exhibited unusual discrepancies between verbal and performance (nonverbal) cognitive abilities favoring the former. Deficits were observed in the social use of language. Father and son had similar abnormalities on magnetic resonance imaging examination. Potential differences between higher-functioning autism and Asperger's syndrome are important areas for future research.

Adolescent↗
PubMed1996

Childhood and adolescent psychosis: a review of the past 10 years.

OBJECTIVE: Developmental aspects of psychosis are reviewed and related to the more frequent psychotic conditions in children and adolescents. METHOD: The review of the recent literature focuses on developmental aspects of psychotic phenomena, i.e., hallucinations, delusions, and thought disorder. RESULTS: While the applicability of much early work on this topic is limited, more recent work suggests that psychotic conditions are observed in childhood and increase in frequency during adolescence. CONCLUSIONS: Developmental factors in the expression of psychosis are relevant to the diagnosis and treatment of such conditions.

Adolescent↗
PubMed1995

Childhood disintegrative disorder: results of the DSM-IV autism field trial.

OBJECTIVE: This report is concerned with the classification of children in whom an "autistic-like" syndrome develops after some years of normal development. In DSM-IV the term "childhood disintegrative disorder" (CDD) is used to describe such cases. METHOD: Data collected as part of the international, multisite DSM-IV field trial for autism and related conditions were examined and cases that met DSM-IV criteria for CDD were identified. RESULTS: In 16 cases the clinician had given a CDD diagnosis; in an additional 10 cases criteria for the condition were met even though this diagnosis was not given by the clinician rating the case. CONCLUSIONS: The available data suggest that CDD cases can be differentiated from those with autism; these two groups appear to differ in important ways. The identification of cases of CDD may be of particular importance for research.

Adolescent↗
PubMed1995

A case-controlled study of repetitive thoughts and behavior in adults with autistic disorder and obsessive-compulsive disorder.

OBJECTIVE: The purpose of this study was to investigate the types of repetitive thoughts and behavior demonstrated by adults with autistic disorder and compare them with those of age- and sex-matched adults with obsessive-compulsive disorder. METHOD: Fifty consecutive patients admitted to the Yale Adult Pervasive Developmental Disorders (Autism) Clinic with a primary diagnosis of autistic disorder (DSM-III-R and DSM-IV) completed the symptom checklist of the Yale-Brown Obsessive Compulsive Scale. Types of current obsessions and compulsions were evaluated. The comparison group consisted of 50 age- and sex-matched adults with obsessive-compulsive disorder (without tics) (DSM-III-R and DSM-IV). RESULTS: Direct discriminant function analysis showed that the patients with autistic disorder could be distinguished from those with obsessive-compulsive disorder on the basis of the types of current repetitive thoughts and behavior that they demonstrated. Compared to the obsessive-compulsive group, the autistic patients were significantly less likely to experience thoughts with aggressive, contamination, sexual, religious, symmetry, and somatic content. Repetitive ordering; hoarding; telling or asking (trend); touching, tapping, or rubbing; and self-damaging or self-mutilating behavior occurred significantly more frequently in the autistic patients, whereas cleaning, checking, and counting behavior was less common in the autistic group than in the patients with obsessive-compulsive disorder. In addition, a specific subset of seven obsessive-compulsive variables from the Yale-Brown Obsessive Compulsive Scale symptom checklist was identified that reliably predicted membership in the autistic group. CONCLUSIONS: These results suggest that the repetitive thoughts and behavior characteristics of autism differ significantly from the obsessive-compulsive symptoms displayed by patients with obsessive-compulsive disorder. Future studies are warranted to assess the treatment response and neurobiological underpinnings of repetitive thoughts and behavior in patients with autism and obsessive-compulsive disorder.

Adolescent↗
PubMed1994

Noradrenergic and adrenergic functioning in autism.

A neurochemical assessment of noradrenergic and adrenergic functioning was carried out with autistic patients and normal control individuals. Norepinephrine and related compounds were measured in autistic (n = 17 unmedicated, 23 medicated; age range 9-29 years old) and normal controls (n = 27; age range 9-36 years old). Plasma levels and urinary excretion of 3-methoxy-4-hydroxy-phenylglycol (MHPG) were measured, as were urinary excretion rates of norepinephrine (NE), epinephrine (EPI), and vanillylmandelic acid (VMA). No significant group mean differences were seen between the autistic and control groups. In both the autistic and control groups urinary excretion rates of norepinephrine and epinephrine were substantially higher in the afternoon-evening (5-11 PM) compared to the overnight (11 PM-7 AM) collection period. Based on our neurochemical assessment, marked abnormalities in basal noradrenergic functioning do not appear to be present in autism.

Adolescent↗
PubMed1994

Field trial for autistic disorder in DSM-IV.

OBJECTIVE: This project focused on the development of the definition of autism for DSM-IV. METHOD: Multiple sites were involved in obtaining information regarding 977 patients with the following clinician-assigned diagnoses: autism (N = 454), other pervasive developmental disorders (N = 240), and other disorders (N = 283). A standard coding system was used, and the raters (N = 125) had a range of experience in the diagnosis of autism. Patterns of agreement among existing diagnostic systems were examined, as was the rationale for inclusion of other disorders within the class of pervasive developmental disorders. RESULTS: The DSM-III-R definition of autism was found to be overly broad. The proposed ICD-10 definition most closely approximated the clinicians' diagnoses. Inclusion of other disorders within pervasive developmental disorders appeared justified. Partly on the basis of these data, modifications in the ICD-10 definition were made; this and the DSM-IV definition are conceptually identical. CONCLUSIONS: The resulting convergence of the DSM-IV and ICD-10 systems should facilitate both research and clinical service.

Age of Onset↗
PubMed1993

Sex differences in pervasive developmental disorders.

Assessed differences in sex ratio, severity of associated mental retardation, and various metrics of severity of autism in autistic, PDD-NOS, and developmentally disordered (non-PDD) cases. Males with autism were more frequent than females, particular at higher IQ levels. The three clinical groups differed, in expected ways, in the various measures of severity of autism with the PDD-NOS cases being intermediate between the strictly diagnosed autistic group and the non-PDD developmental disordered group. Sex differences were primarily confined to IQ; sex differences in other metrics of severity of autism were not prominent. Implications for future research are discussed.

Adolescent↗
PubMed1993

Quantifying social development in autism.

OBJECTIVE: This study was concerned with the development of quantitative measures of social development in autism. METHOD: Multiple regression equations predicting social, communicative, and daily living skills on the Vineland Adaptive Behavior Scales were derived from a large, normative sample and applied to groups of autistic and nonautistic, developmentally disordered children. Predictive models included either mental or chronological age and other relevant variables. RESULTS: Social skills in the autistic group were more than two standard deviations below those predicted by their mental age; an index derived from the ratio of actual to predicted social skills correctly classified 94% of the autistic and 92% of the nonautistic, developmentally disordered cases. CONCLUSIONS: The findings are consistent with the idea that social disturbance is central in the definition of autism. The approach used in this study has potential advantages for providing more precise measures of social development in autism.

Adolescent↗
PubMed1993

Elective mutism and mental retardation.

The association of elective mutism and mental retardation is noted. Two cases of elective mutism associated with mental retardation are presented. Both individuals had long-standing patterns of inhibition, shyness, and anxiety manifested by general refusal to talk outside the home, particularly at school. The importance of assessment of intellectual functioning and linguistic skills for the establishment of intervention priorities and clinical management is discussed. The possibility of the presence of mental retardation in individuals with elective mutism should be considered.

Adolescent↗
PubMed1992

Three diagnostic systems for autism: DSM-III, DSM-III-R, and ICD-10.

ICD-10 draft research criteria for childhood autism were applied to a previously published data set comparing DSM-III and DSM-III-R to clinicians' diagnoses of autism. The ICD-10 approach paralleled clinicians' patterns of diagnosis and, to a lesser extent, the DSM-III system. Relative to either clinicians, DSM-III, or ICD-10 the DSM-III-R system overdiagnosed the presence of autism. Implications for research and for future revision of diagnostic criteria are discussed.

Adolescent↗
PubMed1992

Childhood disintegrative disorder: issues for DSM-IV.

Childhood disintegrative disorder, also known as Heller syndrome or as disintegrative psychosis, is a relatively uncommon condition which has variably been included in official diagnostic systems. Available evidence regarding the validity of this diagnostic concept, particularly with regard to autism, supports inclusion of the category in DSM-IV. Proposed criteria and narrative description for the disorder are presented.

Adolescent↗
PubMed1992

Postural control in children with autism.

Postural control was evaluated in samples of autistic, normal, and mentally retarded children in this pilot study using a recently developed, computerized posturographic procedure. A battery of postural positions was administered including postures involving some degree of "stress" (e.g., occluded vision or standing on pads). The postural patterns of children with autism differed from those observed in normal children, in mentally retarded children, and in adults with vestibular disorders. In comparison to normal children the autistic subjects were less likely to exhibit age-related changes in postural performance and postures were more variable and less stable with more lateral sway. Autistic subjects also exhibited a "paradoxical" response of greater stability with more "stressful" postures, putting excessive weight on one foot, one toe, or one heel. The implications for neuroanatomical models of autism are discussed.

Autistic Disorder↗
PubMed1992

Clomipramine in autism: preliminary evidence of efficacy.

This report provides preliminary evidence for the efficacy of clomipramine in the treatment of young adults with autistic disorder. Four of five outpatients with autistic disorder showed significant improvement in social relatedness, obsessive compulsive symptoms, and aggressive and impulsive behavior with clomipramine treatment. These findings are consistent with previous evidence, suggesting that serotonin neurotransmission may be relevant to the treatment, and possibly the pathophysiology, of some symptoms of autistic disorder.

Adolescent↗
PubMed1992

Development of low- and high-functioning autistic children.

Aspects of developmental sequences and structures were assessed in low- and high-functioning autistic and non-autistic developmentally disabled children. Specific developmental issues examined included sequences, regressions and profiles. Classification into the high- or low-functioning groups was based on a full scale IQ cutoff of 50. In general, there were few differences in the sequences of development among the groups. However, the autistic children were more likely than non-autistic children to display developmental regressions and unevenness across developmental domains. These developmental peculiarities were more pronounced in the low- as compared to high-functioning autistic children. These findings are discussed with regard to issues of developmental processes, classification and autism.

Autistic Disorder↗