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The effect of stimulant medication in childhood-onset pervasive developmental disorder--a case report.

Pharmocological treatment with stimulant medication in childhood schizophrenia and pervasive developmental disorders often renders poor, but occasionally encouraging results. This report describes a case of childhood-onset pervasive developmental disorder in which long-term treatment with 40 mg methylphenidate per day brought about an initial improvement but subsequent deterioration of the child's behavior. Theoretical and practical issues concerning the use of stimulants in pervasive developmental disorder are discussed.

Attention Deficit Disorder with Hyperactivity↗

Visual information processing in high-functioning individuals with autism spectrum disorders and their parents.

The authors assessed visual information processing in high-functioning individuals with pervasive developmental disorders (PDD) and their parents. The authors used tasks for contrast sensitivity, motion, and form perception to test visual processing occurring relatively early and late in the magnocellular-dorsal and parvocellular-ventral pathways. No deficits were found in contrast sensitivity for low or high spatial frequencies or for motion or form perception between individuals with PDD in comparison with a matched control group. Individuals with PDD performed equally with or better than controls on motion detection tasks. In addition, the authors did not find differences on any of the tasks between parents of the PDD group and matched control parents. These results indicate that high-functioning individuals with PDD and their parents are able to process visual stimuli that rely on early or late processing in the magnocellular-dorsal and parvocellular-ventral pathways as well as controls.

Adolescent↗

[Review on the study of the theory of the mind in pervasive development disorders and schizophrenia].

The theory of mind (ToM) is a new concept which could be defined as the ability to make inferences on the intentions of others. This capacity has been used to explain childhood autism symptoms and recently an attempt has been made to refer it to schizophrenia. The authors aim to review the theory of mind concept, the different questions that could appear in neurocognitive sciences and the utilities that this hypothetical model has been given in the clinical practice. The authors also consider the contributions and restrictions that its use has in the field of pervasive developmental disorders and schizophrenia.

Child↗

Landau-Kleffner syndrome with onset at 18 months and an initial diagnosis of pervasive developmental disorder.

We report one of the youngest and most intensively studied cases of Landau-Kleffner syndrome, with a follow-up of 5 years. The boy developed normally until the age of 18 months when he had two attacks, possibly epileptic. Electroencephalogram (EEG) was normal. Over the next 5 months he lost his six to ten words, did not engage with other children and became mute. When he was 34 months old a child-psychiatrist suggested a diagnosis of pervasive developmental disorder or developmental dysphasia. An EEG 3 months later showed abnormalities typical of Landau-Kleffner syndrome. His non-verbal abilities were normal as well as his neurological examination and brain magnetic resonance imaging (MRI). A trial of clobazam and vigabatrin was unsuccessful. When he was 4 years and 9 months old he was treated with corticosteroids and within 3 months his vocabulary increased from the standard for 1 1/2 years of age to that for 2 1/2 years of age. His language abilities continued to improve slowly until a stagnation period at the age of 6 years and 9 months. A second course of corticosteroids improved his comprehension and vocabulary to an almost normal level, and his EEG normalized. A total of 11 EEGs were obtained; all included sleep, but continuous spike and wave during slow sleep was never documented. This report illustrates that Landau-Kleffner syndrome should be considered as an alternative diagnosis in children diagnosed with developmental dysphasia. An EEG including sleep should be considered, and in the presence of abnormalities a trial of anti-epileptic drugs or corticosteroids should be undertaken.

Brain↗

Low-dose neuroleptic therapy for children with childhood-onset pervasive developmental disorder.

An open study of the therapeutic effects of low-dose neuroleptic treatment was performed on 12 consecutively hospitalized children, aged 7-11, who satisfied DSM-III criteria for childhood-onset pervasive developmental disorder. While receiving an average dose of 0.04 mg/kg per day of haloperidol or fluphenazine hydrochloride, the patients exhibited significant reductions in hyperactivity and aggressive symptoms and significant improvement in peer relations. This dose of neuroleptic was associated with minimal side effects. The authors conclude that low doses of potent neuroleptics may be effective treatment for some patients suffering from childhood-onset pervasive developmental disorder.

Behavior Therapy↗

School refusal in pervasive developmental disorders.

Of 135 autistic and/or mentally retarded youngsters, 30 with pervasive developmental disorders and 2 with nonautistic mental retardation showed school refusal according to its modified definition. School refusal was significantly more frequent in other PDDs than in nonautistic mental retardation. The intellectual level was significantly higher in PDD children with school refusal than those without it. A certain level of mental development and obsessive tendency appear necessary for PDD children to develop school refusal. In order to treat school refusal in PDD, it is important to make school a pleasant place to go and to encourage the child to attend.

Absenteeism↗