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PubMed2004

Effects of peer training and written text cueing on social communication of school-age children with pervasive developmental disorder.

This study consecutively examined the effects of 2 social interventions-- peer training and written text treatment--on the social communication of 5 elementary students with pervasive developmental disorder. Each child with autism was paired with 2 peers without disabilities to form 5 triads. In Intervention 1 (peer training), peers were taught to use 5 facilitative social skills over 5 days. After peer training, 4 children with autism increased or used more stable rates of initiations and contingent responses overall. However, all children continued to demonstrate deficits in specific social-communication skills. Once Intervention 2 (direct instruction using written text cues) was implemented, increased use of 3 different communication skills was observed across all 5 participants. In addition, social validity outcomes revealed improved quality of child-peer interactions, 2 teacher reports of improved social skill development, and improved acceptance and friendship ratings for the children with autism. Results support the use of written text cues to improve children's social communication with peers, and suggest that combining approaches may be necessary to improve the quality of children's relationships.

Asperger Syndrome↗
PubMed1999

Olanzapine treatment of children, adolescents, and adults with pervasive developmental disorders: an open-label pilot study.

This pilot study examined the efficacy and tolerability of olanzapine in the treatment of children, adolescents, and adults with pervasive developmental disorders (PDDs). Eight patients with principal diagnoses (DSM-IV) of autistic disorder (N = 5) or PDD not otherwise specified (N = 3) were given olanzapine in an open-label, prospective fashion for 12 weeks. Clinical ratings were obtained at baseline and at the end of weeks (EOWs) 4, 8, and 12. Seven of eight patients completed the 12-week trial, and six of the completers were deemed clinical responders as measured by ratings at the EOW 12 of "much improved" or "very much improved" on the global improvement item of the Clinical Global Impression Scale. Significant improvements in overall symptoms of autism, motor restlessness or hyperactivity, social relatedness, affectual reactions, sensory responses, language usage, self-injurious behavior, aggression, irritability or anger, anxiety, and depression were observed. Significant changes in repetitive behaviors were not observed for the group. The EOW 12 mean +/- SD daily dose of olanzapine was 7.8 +/- 4.7 mg/day. The drug was well tolerated with the most significant adverse effects noted to be increased appetite and weight gain in six patients and sedation in three. With respect to weight gain, the mean +/- SD weight for the group increased from 137.50 +/- 55.81 pounds (62.50 +/- 25.37 kilograms) at baseline to 155.94 +/- 55.13 pounds (70.88 +/- 25.06 kilograms) at EOW 12. No evidence of extrapyramidal side effects or liver function abnormalities was seen. These preliminary results suggest that olanzapine may be an effective and well tolerated drug in targeting core and related symptoms of PDDs in children, adolescents, and adults. Further studies, particularly those that are placebo-controlled and double-blinded, are indicated to better define the clinical use of olanzapine in these patient populations.

Adolescent↗
PubMed2005

Parental perception of sleep problems in children of normal intelligence with pervasive developmental disorders: prevalence, severity, and pattern.

OBJECTIVE: This study compares parents' perceptions of the prevalence, severity, and pattern of sleep problems in children of normal intelligence with pervasive developmental disorders (PDDs) with a normative comparison group of children. METHOD: A survey including the Children's Sleep Habits Questionnaire was mailed to a sample of parents of children (age range 5-12 years) with PDDs (diagnosed by the Autism Diagnostic Interview-Revised) obtained by chart review of the past 7 years and to parents of comparison children matched on age, gender, and postal code. RESULTS: The response rate in the PDD group was 82.2% (37/45) and 55.8% (43/77) in the comparison group. By individually matching, 23 pairs were obtained. The prevalence of sleep problems in the PDD group was reported by parents as being significantly higher than in the comparison group (78% and 26%, respectively; p < .002), as was the severity (mean score 48.2 and 39.0, respectively; p < .001). Values for four of eight sleep subscales including sleep onset delay, sleep duration, sleep anxiety, and parasomnias were significantly higher in the PDD group. CONCLUSIONS: Parents report that sleep problems are significantly more prevalent and severe in children of normal intelligence with PDDs compared with normally developing children, and the pattern appears diverse. Sleep problems in children with PDDs require further research and clinical attention.

Canada↗
PubMed2006

Visual completion and complexity of visual shape in children with pervasive developmental disorder.

Much evidence has been gathered for differences in visual perceptual processing in individuals with Autistic Spectrum Disorder. The presence of the fundamental process of visual completion was tested in a group of children with Pervasive Developmental Disorder (PDD), as this requires perceptually integrating visual structure into wholes. In Experiment 1, it was investigated whether visual completion is present for simple partly occluded shapes in a group of children with PDD and a typically developing group. In Experiment 2, the presence of contextual influences in visual completion was investigated for the two groups. A total of 19 children with PDD and 28 controls who were matched for chronological age and IQ took part in two primed-matching tasks. For both groups, visual completion was present and for both groups, contextual influences were found to be dominant in this process. However, only for the group with PDD no priming effects (PEs) were found from less regular primes on congruent test pairs. The group with PDD did integrate visual information into wholes and did this in a contextually dependent way. However, for more complex shapes, visual completion is weaker for this group.

Autistic Disorder↗
PubMed1998

[The development consultation for children in whom the physician suspects a developmental disorder: early experiences in Maastricht].

The so-called development consultation of the Heuvelland health care organization in Maastricht was organized with a view to early detection of developmental disorders in young children (< or = 6 years), thereby minimizing dysfunctioning. Health centre physicians, general practitioners and school doctors can refer children aged 0-6 years to this combined consultation hour of a paediatrician, a children's neurologist, a children's physiotherapist and in some cases, an educationalist and a speech therapist. After the starting-up phase, the number of referred children was three to six per month. The referring physician is usually present at the joint consultation after the examinations. At this meeting it is attempted to arrive at a diagnosis or at least to draw up a treatment plan. After the meeting, the child's parents or guardians are informed of the team's findings. The first group of 60 children included 9 with a cerebral paresis and 18 with retarded motor development and speech retardation; 8 children were referred for exclusion of neurological/cerebral abnormalities.

Child↗
PubMed1993

Lack of cognitive impairment in first-degree relatives of children with pervasive developmental disorders.

OBJECTIVE: The objective of this study was to test the hypothesis that mild cognitive impairments aggregate in the unaffected first-degree relatives of probands with autism or pervasive developmental disorders (PDD). METHOD: The unaffected siblings and parents of 52 PDD probands and 33 Down syndrome and low birth weight controls were administered a battery of psychometric tests. The tests included measures previously found to be depressed in siblings of autistic children as well as cognitive deficits seen in PDD subjects of normal IQ. In addition, the Vineland Adaptive Behavior Scales were administered to siblings to measure the social-communication impairments found in PDD. RESULTS: Neither the siblings nor parents of the PDD probands demonstrated lower cognitive or adaptive behavior scores compared with controls. Developmental histories did not reveal greater rates of social, cognitive, or language delays, nor was there evidence to suggest that relatives of subgroups of PDD probands were different from each other. CONCLUSION: These findings indicate that, apart from relatives with PDD, cognitive and social impairments do not aggregate in the families of PDD probands.

Adolescent↗
PubMed2005

Empathic accuracy in adults with a pervasive developmental disorder during an unstructured conversation with a typically developing stranger.

The present paper consists of two parts. In the first part, eleven high-functioning adults with pervasive developmental disorder (PDD) participated and were videotaped with a concealed camera while having an initial conversation with a typically developing stranger. Analyses revealed some significant differences with regard to the dyad members' overt behaviours. Contrary to our main hypothesis, analyses of the covert behaviour revealed that the participants with PDD did not differ from the typically developing participants in the ability to infer the thoughts and feelings of their interaction partner. The second part indicated that the inference ability of both groups was independent of the dyad members' behavioural characteristics and the content of the dyad members' thoughts and feelings. Issues addressed in this paper include the relation of scriptal knowledge to social functioning, and the advantage participants with PDD take from more structured interactions compared with less structured interactions.

Adult↗
PubMed2000

Unresponsiveness to psychosocial stress in a subgroup of autistic-like children, multiple complex developmental disorder.

In this study, we tried to replicate the finding of a diminished cortisol response to stress in autistic-like patients in a more homogenous Multiple Complex Developmental Disorder (MCDD) group. MCDD forms a distinct group within the autistic-like disorders, characterized by impaired regulation of anxiety and affective state, impaired social behavior/sensitivity, and thought disorder. A number of MCDD children develop schizophrenia in adult life. Responses to a psychosocial stressor, consisting of speaking in public while recorded on video, were measured in 10 MCDD children and 12 healthy control children. The public speaking test was imbedded in a two-hour test session, and compared to a control test session. Hypothalamic-pituitary-adrenal (HPA) responses were measured on salivary cortisol at about 20-minute intervals. Heart rate was measured continuously. Delta AUC's were computed for both heart rate (dAUCHR) and salivary cortisol (dAUCCORT), as a measure of response to the test.The public speaking task resulted in significant responses in heart rate and salivary cortisol in healthy control children, but not in MCDD children. dAUCHR was 3.28+/-2.37 in healthy control children, but -0.09+/-1.73 in MCDD children (t=3.31, P<0.01). dAUCCORT was 3.22+/-3.16 in healthy control children, but 0. 17+/-1.74 in MCDD children (t=2.72, P<0.05).The impaired responses to psychosocial stress found in MCDD children may be the result of their limited abilities to react adequately to their (social) environment. The same impairment in stress processing has been found in schizophrenia, and might be a factor in the vulnerability of these MCDD children to develop schizophrenia.

Adrenal Glands↗
PubMed2000

Macrocephaly in autism and other pervasive developmental disorders.

To assess the prevalence of macrocephaly (head circumference > or = 1.88 standard deviations above normative data for age and sex or > 97th centile) in autism and other pervasive developmental disorders, 41 children with autism, and a comparison group of 21 children with tuberous sclerosis complex (TSC) or an unspecified seizure disorder were studied. Familiality of head circumference was also assessed from measurements of 133 first-degree relatives. Significantly higher rates of macrocephaly were found in probands with autism (12.2%) and their first-degree relatives (15.5%) when compared against a published normative sample. The incidence of macrocephaly in the comparison group of probands with TSC and seizure disorder (9.5%) and their first-degree relatives (8.3%) was higher than normative data as well, although the relation between macrocephaly and autism was more pronounced. Head circumference and extreme scores reflecting macrocephaly were moderately heritable in the present sample (H2 = 0.47). The increased prevalence of macrocephaly in relatives of children with autism compared with control children suggests that this characteristic may be a familial risk factor in the pathogenesis of autism.

Adolescent↗
PubMed1998

Buspirone in the management of anxiety and irritability in children with pervasive developmental disorders: results of an open-label study.

BACKGROUND: We evaluated the efficacy and safety of buspirone in the management of anxiety and irritability in children with pervasive developmental disorders (PDD). METHOD: Twenty-two subjects, 6 to 17 years old, with DSM-III-R diagnosed PDD-NOS (N = 20) or autistic disorder (N = 2), were included. They were treated with buspirone in dosages ranging from 15 to 45 mg/day in an open-label trial lasting 6 to 8 weeks. Responders continued buspirone treatment and were followed up for up to 12 months. RESULTS: Nine subjects had a marked therapeutic response and 7 subjects a moderate response on the Clinical Global Impressions (CGI) scale after 6 to 8 weeks of treatment. Side effects were minimal, except for 1 patient who developed abnormal involuntary movements. CONCLUSION: These results suggest that buspirone may be useful for treating symptoms of anxiety and irritability in children with PDD.

Adolescent↗
PubMed1987

Possible relationship between pervasive developmental disorders and platelet monoamine oxidase activity.

1. The present study was undertaken to determine if the platelet monoamine oxidase (MAO) activity of children with childhood-onset Pervasive Developmental Disorders (PDD), atypical PDD and autistic children differs from MAO of normal children of the same age. 2. The kinetic parameters of MAO activity (Km and Vmax for kynuramine as substrate in 100 mM sodium phosphate buffer, pH 7.4 at 37 degrees C) were determined for platelets from autistic (N = 6), childhood onset PDD (N = 6) and atypical PDD (N = 6) children and 14 controls aged 6-10 years. 3. PDD children had significantly lower Km (4.41 +/- 0.26 vs 5.30 +/- 0.23 microM) and Vmax (16.77 +/- 1.56 vs 22.15 +/- 2.16 nmol h-1 mg protein-1) than control children. The reduction in Vmax was demonstrable in MAO activity measured with 100 microM substrate (14.93 +/- 1.13 vs 20.96 +/- 2.10 nmol h-1 mg-1). 4. These data show that childhood-onset PDD patients, in which the syndrome was complete, presented the lowest levels of platelet MAO activity.

Autistic Disorder↗
PubMed1995

Is it possible to assess the impact of abuse on children with pervasive developmental disorders?

Although it is now recognized that children may exhibit widespread symptoms of stress following exposure to abuse or neglect, the impact of traumatic experiences on children with pervasive developmental disorders has received little attention. The present paper describes a strategy devised to assess the long-term effects of abuse on a group of children who had attended a specialist autistic school where physical and emotional mistreatment of pupils was well documented. Because most of the children had very limited communication skills, the evidence relied heavily on retrospective parental reports. Despite the problems inherent in using such data it was possible to derive reliable measures that could be used to test hypotheses about predicted patterns of behavioral change, based on work with other children who have been abused. In most cases, too, parental reports could be corroborated by information from other sources. Consistent patterns in both the nature and timing of behavioral disturbances were found, which seemed to relate specifically to the period of abuse at the school.

Activities of Daily Living↗
PubMed2004

Aripiprazole for maladaptive behavior in pervasive developmental disorders.

OBJECTIVE: The aim of this study was to obtain preliminary data regarding the effectiveness and tolerability of aripiprazole in the treatment of children and adolescents with a pervasive developmental disorder (PDD). METHOD: Five youths (mean age, 12.2 years; range, 5-18 years) meeting Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) criteria for a PDD received a naturalistic, open-label trial of aripiprazole (mean dosage, 12.0 mg/day; range, 10-15 mg/day) for a minimum of 8 weeks (mean duration, 12 weeks; range, 8-16 weeks). RESULTS: All 5 patients were judged to be responders, as determined by a Clinical Global Impressions-Improvement (CGI-I) scale rating of "much improved" or "very much improved." Aripiprazole was well tolerated. No extrapyramidal symptoms or clinically significant changes in heart rate or blood pressure occurred during the short-term trials. Two of 5 patients experienced mild somnolence. Two subjects lost weight, 2 subjects had no change, and 1 subject gained weight (mean change, -8.2 lbs; range, -30 to +1 lb). The weight loss was likely the result of the discontinuation of atypical antipsychotics that had led to significant weight gain. CONCLUSIONS: This case series describes the effectiveness of aripiprazole in the treatment of maladaptive behaviors in 5 patients with a PDD. No significant adverse effects emerged during these short-term trials. Additional research is needed to support these preliminary findings.

Adolescent↗
PubMed1996

High phenotypic correlations among siblings with autism and pervasive developmental disorders.

The objective of this study was to examine familial factors influencing clinical variation in sibships that contained at least 2 children affected with autism or another form of pervasive developmental disorder (PDD). The sample included a total of 60 families, 23 with multiple cases of PDD and 37 with a single affected child. Measurements of IQ, adaptive behaviors in socialization and communication, and autistic symptoms were taken on all affected children. A high intraclass correlation, especially on IQ and an index of social behaviors, was observed between affected children from the same family. In contrast, low correlations were observed on measurements of IQ and adaptive behavior between affected and unaffected children from the same family. These data indicate that variation in severity of PDD is influenced by familial, and probably genetic, mechanisms. The results are discussed in relation to current theories on the genetics of autism and the heritable mechanisms underlying variations in clinical severity.

Autistic Disorder↗
PubMed1998

Absence of the fragile X CGG trinucleotide repeat expansion in girls diagnosed with a pervasive developmental disorder.

The purpose of this study was to determine the prevalence of the fragile X (FRAX) CGG trinucleotide expansion in a population of young girls (n = 45) diagnosed with pervasive developmental disorder (PDD). Their mean age was 43.7 months (range, 25 to 132 months). Diagnoses included autistic disorder (n = 20), PDD (n = 23), and Asperger's syndrome (n = 2). Molecular FRAX testing was performed on all patients by using the Southern gene blot technique. Genomic DNA was digested with both EcoRI and EagI, fractionated on agarose gel, and blotted and probed with the radiolabeled StB12.3 FMR-1 probe. None of the subjects were found to have an expansion of CGG in either the 2.8 kb or 5.2 kb fragments. A 95% CI, for the prevalence of the FRAX mutation in female subjects with PDD, has an upper bound of 2.9%. We conclude that the prevalence of FRAX positivity in girls with PDD is lower than previously reported. This raises the question of whether any association between FRAX and PDD in female subjects is specific to PDD or is related rather to the presence of mental retardation.

Autistic Disorder↗
PubMed2003

Low-dose fluvoxamine treatment of children and adolescents with pervasive developmental disorders: a prospective, open-label study.

The objective of this study was to assess the efficacy and tolerability of low-dose fluvoxamine (1.5 mg/kg/day) in youngsters with pervasive developmental disorders (PDDs). This was a prospective, open-label trial that included 18 subjects with a mean age of 11.3 +/- 3.6 years. Fourteen children (78%) completed the 10-week study. Premature discontinuation due to behavioral activation occurred in three participants. Although there was no response for the group as a whole, eight subjects (including all four females) were considered at least partial responders in intent-to-treat analyses. Neither pubertal status nor serotonin levels predicted clinical response. Fluvoxamine can be beneficial in the treatment of select children and adolescents with PDDs. Gender differences in selective serotonin reuptake inhibitor (SSRI) response warrant further investigation.

Adolescent↗
PubMed2026

Cohesin variants associated with human reproductive and developmental disorders.

The cohesin complex is an evolutionarily conserved multi-subunit protein assembly essential for sister chromatid cohesion, meiotic recombination, DNA double-strand break repair, and transcriptional regulation. Pathogenic variants in its subunits are implicated in a spectrum of reproductive and developmental disorders, including non-obstructive azoospermia, premature ovarian insufficiency, reproductive aging, aneuploidy, Cornelia de Lange syndrome, Roberts syndrome, cancer, and neuropsychiatric disease. Consequently, identifying cohesin mutations is a priority for precision diagnostics and personalized medicine. This review systematically summarizes the cohesin variants linked to these pathologies, exploring their molecular mechanisms and clinical manifestations. A deeper understanding of these variants is crucial not only for deciphering disease etiology but also for guiding the development of targeted diagnostic strategies and therapeutic interventions, ultimately improving patient management and outcomes.

Humans↗
PubMed1996

The effect of selection criteria on outcome studies of children with pervasive developmental disorders (PDD).

The objective of this paper is to see whether regression to the mean biases the differences on outcome observed between children with Asperger syndrome and autism. Children with pervasive developmental disorders (PDD) and normal nonverbal IQ were divided into those with Asperger syndrome and autism. It was hypothesized that IQ in the autistic children would fall at the 2-year outcome assessments since the autistic group represented a subgroup selected on the basis of extreme scores on a single measure. In fact, the Asperger syndrome group experienced a significant drop in nonverbal IQ contrary to expectation. Serial measurements of nonverbal IQ at inception indicated that this drop was probably a function of high initial nonverbal IQ scores that fall over time due to increasing complexity of problem-solving tests. The results are discussed in relation to outcome studies of high functioning children with PDD.

Autistic Disorder↗