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PubMed2000

Visual sustained attention in a child psychiatric population.

OBJECTIVE: To increase knowledge of the diversity and specificity of sustained attention deficits in children with attention-deficit hyperactivity disorder (ADHD), with special reference to the issue of distinguishing between children with ADHD and children with other psychiatric diagnoses. METHOD: A visual sustained attention task was used to compare 52 boys with ADHD with 55 normal controls, 29 boys with oppositional defiant disorder or conduct disorder (ODD/CD), 29 boys with anxiety or dysthymia (ANX/DYS), 43 boys with pervasive developmental disorder, 24 boys with ADHD plus ODD/CD, and 14 boys with ADHD plus ANX/DYS. RESULTS: Compared with normal controls, children with ADHD were slower, were more inaccurate, were more impulsive, were less responsive to feedback, and showed less perceptual sensitivity and stability of performance, resulting in a marked decrease in vigilance over time. Unresponsiveness to feedback and the extent of the decrease in vigilance during time on task were found to be the only factors that distinguished children with ADHD from children with other diagnoses. CONCLUSION: Although only children with ADHD are characterized primarily by "attention deficit," sustained attention deficit is common to a certain extent to all children with psychiatric disorders.

Anxiety↗
PubMed1991

Personality adjustment and social support of parents who care for children with pervasive developmental disorders.

The goal of this study was to examine the degree of personality adjustment and perceived social support of parents who care for children with pervasive developmental disorders. Data were collected with the California Q-Set (a personality measure) and the Norbeck Social Support Questionnaire. Personality adjustment of the parents was found to be significantly less than optimal, with a high degree of anxiety, minimal ego resilience, and use of defensive coping processes. Siblings of the child with the disorder and mothers of the parents were those most frequently identified as providing support to the caregiver, although friends, special education teachers, and daycare staff were the individuals whose support was most significantly related to greater amounts of perceived affection and affirmation, tangible aid, and concrete caregiving assistance. In fact, the more the caregivers depended upon their families for support, the less well adjusted were the caregivers on the personality measure. The implications of the findings for caregivers and their families are discussed.

Adaptation, Psychological↗
PubMed2005

The use of psychostimulants in pervasive developmental disorders.

Many children with Pervasive Developmental Disorders (PDD) display problematic behaviors similar to those seen in children with Attention Deficit Hyperactivity Disorder (ADHD). This paper will look at the controversy concerning diagnosing comorbid ADHD in children who meet criteria for PDD and review the existing literature examining the efficacy of stimulants in these particular set of behaviors or symptom clusters (hyperactivity, impulsivity and inattention). The potential drawbacks of using stimulants in a population of children and adolescents who exhibit symptoms of PDD and ADHD will be discussed. Finally, this review will also attempt to define potential areas of future research to examine the utility of the psychostimulants in children and adolescents with PDD and symptoms of ADHD.

Adolescent↗
PubMed2006

Cognitive and symptom profiles in high-functioning pervasive developmental disorder not otherwise specified and attention-deficit/hyperactivity disorder.

Age- and IQ-balanced 27 children with high-functioning (IQ>or=70) pervasive developmental disorder not otherwise specified (HPDDNOS) and 27 children with attention-deficit/hyperactivity disorder (ADHD) were compared on the Japanese version of Wechsler Intelligence Scale for Children Third Edition (WISC-III) and the Childhood Autism Rating Scale-Tokyo Version (CARS-TV). Compared with the ADHD children, the HPDDNOS children scored significantly lower on verbal comprehension, vocabulary, and comprehension, but significantly higher on block design. After controlling for the total CARS-TV score, the HPDDNOS children were significantly more abnormal on "relationships with people," "nonverbal communication," and "general impressions," but less abnormal on "near receptor responsiveness" and "activity level." These differences in cognitive and autistic symptom profiles may help professionals to distinguish clinically between both conditions.

Adolescent↗
PubMed2004

An investigation into sub-telomeric deletions of chromosome 22 and pervasive developmental disorders.

Deletions of the sub-telomeric region of chromosome 22 have been associated with mental retardation, developmental delay, and autistic behaviors. This study investigated sub-telomeric anomalies of chromosome 22 using fluorescent in situ hybridization (FISH) probes in 82 subjects diagnosed with autism and atypical autism. No microdeletions were detected in this group. Similar FISH analyses were undertaken on two children with developmental delay, who were ascertained to be ring 22 during routine cytogenetic investigations. One subject was shown to have a microdeletion in the sub-telomeric region tested. Both children met the social and communication cut off for autism on the ADI and but did not meet the cut off for restrictive and repetitive behaviors. Only one of the two children met the criteria for PDD on the ADOS.

Child↗
PubMed1999

A comparison of social skills in adults with autistic disorder, pervasive developmental disorder not otherwise specified, and mental retardation.

We examined the social skills of adults with autism, PDDNOS, and mental retardation. All participants were diagnosed with profound mental retardation. Participants in the autism and PDDNOS groups had been previously diagnosed using the Childhood Autism Rating Scale (CARS) and record review. These diagnoses were confirmed by readministering the CARS by one author and an independent rater. Social skills were assessed by using the Vineland Adaptive Behavior Scales and the Matson Evaluation of Social Skills in the Severely Retarded. Significant differences between the autism and mental retardation groups were found on both measures. The PDDNOS group demonstrated better positive nonverbal social skills than the autism group but not the mental retardation group. Special treatment needs of institutionalized adults with autism appear warranted along with a need to clarify further the differences between PDDNOS and mental retardation.

Adult↗
PubMed2002

Parent information and direct observation in the diagnosis of pervasive and specific developmental disorders.

Children with autism and children with a severe specific receptive language disorder show clear deficits in communicative language skills and social relationships. In this study the usefulness of a standardized parent interview (ADI-R) and a standardized observation schedule (ADOS-G) for the differential diagnosis of these two groups was assessed. Eleven children with early infantile autism and 16 children with a specific receptive language disorder participated. The parent interview was conducted with all parents and the observation schedule was administered to all children. Ten out of 11 children with autism were correctly classified as having autism on the ADI-R and the ADOS-G. One child with a receptive language disorder was falsely classified as having autism on the ADI-R, and none on the ADOS-G. Parent interview provides extensive information on the developmental course of the child. Direct observation gives an overview of actual relevant behavioural problems. The two instruments are complementary in the diagnosis of developmental disorders.

Autistic Disorder↗
PubMed2005

Pharmacologic treatment of behavioral symptoms in autism and pervasive developmental disorders.

Autism and other pervasive developmental disorders (PDDs) are associated with various dysfunctional and problematic behaviors, in addition to the core features of language and social skills dysfunction that define these conditions. Although there is currently no pharmacologic cure for the core features of PDDs, some of the behavioral symptoms may be treated pharmacologically. In addition to relieving some of the daily stress in the lives of patients and their families, improvement of these behavioral symptoms, which include hyperactivity, aggression, tantrums, and self-injury, removes some of the hindrances to other rehabilitative efforts. This article discusses the efficacy and tolerability of various medications and alternative interventions in addressing the symptoms of autism and other PDDs.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

Behavior change in a student with a dual diagnosis of deafness and pervasive developmental disorder: a case study.

The broad term pervasive developmental disorder (PPD) describes a set of symptoms that occur along a continuum of severity; these symptoms are often referred to as autism spectrum disorders (ASDs). Little is known about the incidence and prevalence of ASDs among students who are deaf or hard of hearing (DHH). Teachers of DHH students, who must work with individuals with dual diagnoses, are at a loss for guidance from the literature. The authors review the literature on ASDs (also referred to as PDD) within the DHH population, provide results of a single-subject study to reduce PDD-type behaviors in a child with hearing loss, and argue that teachers of students who are DHH must learn about practices associated with applied behavior analysis as an tool for intervening therapeutically with children with dual diagnoses of hearing loss plus an ASD.

Behavior Therapy↗
PubMed2004

Larger brains in medication naive high-functioning subjects with pervasive developmental disorder.

BACKGROUND: Are brain volumes of individuals with Pervasive Developmental Disorder (PDD) still enlarged in adolescence and adulthood, and if so, is this enlargement confined to the gray and/or the white matter and is it global or more prominent in specific brain regions. METHODS: Brain MRI scans were made of 21 adolescents with PDD and 21 closely matched controls. RESULTS: All brain volumes, except the white matter, were significantly larger in patients. After correction for brain volume, ventricular volumes remained significantly larger in patients. CONCLUSIONS: Patients showed a proportional, global increase in gray matter and cerebellum volume, and a disproportional increase in ventricular volumes. Thus, at least in high-functioning patients with PDD, brain enlargement may still be present in adult life.

Adult↗
PubMed2006

Prevalence of gastrointestinal disorders in adult clients with pervasive developmental disorders.

BACKGROUND: In clients with pervasive developmental disorders (PDD), some authors have noticed the presence of gastrointestinal disorders and behavioural disorders. An augmented prevalence of different histological anomalies has also been reported. The aim of our study is to highlight the prevalence of gastrointestinal disorders in this adult with PDD sample and to demonstrate the importance of accurate evaluation of gastrointestinal disorders in clients with PDD. METHODS: The present comparative study involved 118 clients. Our research was motivated by the clinical observation that behavioural disorders sometimes disappeared with administration of anti-gastric acid or anti-ulcerous medications. It focused on two samples of clients with intellectual disability - those with associated PDD and those without. The presence of gastrointestinal disorders was assessed retrospectively on the basis of hospital records. RESULTS: The prevalence of gastrointestinal disorders reported in clinical files was 48.8% in clients with PDD, as compared with 8.0% in non-PDD clients (P < 0.00001). CONCLUSION: Gastrointestinal disorders, and especially gastro-oesophageal reflux, if neglected, may contribute to behavioural disorders in PDD clients. Moreover, gastrointestinal disorders may be considered as a feature of PDD. We highlight the fact that somatic disorders may coexist in persons with PDD.

Adult↗
PubMed1988

[The classification of pervasive developmental disorders and other disorders: toward the DSM-IV].

Forty years after Kanner's groundbreaking work and many publications later, the outlook for children with autism has not changed markedly. Progress in understanding the etiology, let alone in developing new approaches for treatment, has been extremely slow for this and other serious, early onset disturbances. Historically, disagreements over diagnosis and syndrome definition have impeded research efforts. Indeed, in many cases it is impossible, on reading research reports of even a decade ago, to know exactly what population was being studied. DSM-III has broken new ground in its emphasis on developmental disorders viewed within a multiaxial diagnostic scheme. Increased diagnostic precision should facilitate the application of rigorous bio-behavioral research methods, which, in turn may help increasingly to define homogeneous populations. Refinements of nosology should not be mere academic exercises. Rather, they should suggest hypotheses which are amenable to empirical test. DSM-III, in addition to pointing the way out of the era of psychiatric Babel, has suggested empirical studies which have challenged its assumptions. In the field of nosology, this should be considered a major criterion of success. Changes in nomenclature, while sorely needed, should be undertaken with appropriate skepticism and conservatism and should build upon the foundation provided by DSM-III.

Autistic Disorder↗
PubMed1995

Emotional role-taking abilities of children with a pervasive developmental disorder not otherwise specified.

Seven to 12-year-old children with a Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS) were compared with normal, healthy children of the same age and sex on three different emotional role-taking tasks. In these tasks, children had to use person-specific information to make an inference about another child's emotional reaction and behaviour, Significant differences were found between the PDDNOS group and control group: PDDNOS children performed worse on all three role-taking tasks. However, the differences on one of these tasks could be completely explained by intelligence differences between the two groups. On the other tasks, differences could not or be partially explained by intelligence differences. The results of this study led to the formulation of a more specific hypothesis, namely that PDDNOS children might have problems interpreting social information when affectively charged background information has to be used.

Aptitude↗
PubMed2003

Face recognition in children with a pervasive developmental disorder not otherwise specified.

This study investigates the accuracy and speed of face recognition in children with a Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS; DSM-IV, American Psychiatric Association [APA], 1994). The study includes a clinical group of 26 nonretarded 7- to 10-year-old children with PDDNOS and a control group of 65 normally developing children of the same age. Two computerized reaction time tasks were administered: a face recognition task and a control task designed to measure the recognition of abstract visuospatial patterns. The latter were either easy or difficult to distinguish from a set of alternative patterns. The normally developing children recognized the faces much faster than the hardly distinguishable abstract patterns. The children in the PDDNOS group needed an amount of time to recognize the faces that almost equalled the time they needed to recognize the abstract patterns that were difficult to distinguish. The results suggest that, when processing faces, children with PDDNOS use a strategy that is more attention-demanding and, hence, less automatic or "Gestalt-like" than the one used by the control children. The results are discussed in the light of a theory that explains the development of coherent mental representations.

Attention↗
PubMed2005

Comparison of DSM-IV symptoms in elementary school-age children with PDD versus clinic and community samples.

This study compares DSM-IV symptoms in children (ages 6 to 12 years) with pervasive developmental disorder (PDD), clinic controls, and community-based samples. Parents/teachers completed the Child Symptom Inventory-4 for four samples: PDD (N = 284/284) and non-PDD psychiatric clinic referrals (N = 189/181) and pupils in regular (N = 385/404) and special (N = 61/60) education classes. The PDD group received higher symptom severity ratings than the regular education group, but was similar to the non-PDD clinic sample. Screening prevalence rates were highest for ADHD, ODD, and generalized anxiety disorder. PDD subtypes exhibited differentially higher rates of psychiatric symptoms. The magnitude of rater and gender differences in symptom severity ratings was modest. Clinic-referred children with PDD exhibit a pattern of psychiatric symptoms highly similar to nonPDD clinic referrals. Although much additional research is needed on comorbidity, these symptoms have important treatment implications.

Anxiety Disorders↗
PubMed1993

Dysfunctional attention in autistic savants.

A dysfunctional attention hypothesis of the basis of savant skills was tested with a series of computerized tasks that assessed the ability to divide, shift, direct, and sustain attention. Ten healthy men with pervasive developmental disorders and unusual calendar-calculating skill, and 10 age- and sex-matched controls were tested. There were four general findings. First, the savants and controls did not differ on a measure of visual sustained attention. Second, the savants failed to detect rare auditory targets significantly more than did the controls. Third, the savants were unable to efficiently divide their attention when required to detect both visual and auditory targets simultaneously. Finally, deficient orienting or a deficit in shifting selective attention from one stimulus location to another was evidenced in overall slower reaction times for the savants across tasks requiring shifts and redirecting of attention. This deficit was attributed to an inability to disengage attention as a result of deficient orienting and overselectivity.

Acoustic Stimulation↗
PubMed1988

Psychiatric disability in female carriers of the fragile X chromosome.

Fragile X syndrome, an X-linked genetic condition, is an important genetic cause of mental retardation in males. In addition to mental retardation, hemizygous males with fragile X syndrome appear to have a greater likelihood of displaying behaviors classified under the diagnostic category of pervasive developmental disorder than would be expected on the basis of mental retardation alone. Although the majority of female heterozygotes with the fragile X genetic defect are of normal intelligence, our clinical work with this population and a recent case report have suggested that females with fragile X syndrome have an increased rate of schizophrenia spectrum and affective disorders. In this study, the relationship of the fragile X genetic defect to psychopathology in female heterozygotes is investigated by psychiatric evaluation of 35 obligate female carriers of the fragile X chromosome and a comparison group of 24 fragile X-negative controls. Female fragile X carriers were found to have a greater frequency of psychopathology associated with schizophrenia spectrum diagnoses, particularly schizotypal features. A weaker association between the fragile X genetic defect and chronic affective disorders was detected. The specificity of the neuropsychiatric phenotype occurring in particular genetic conditions such as the fragile X syndrome adds a potentially valuable tool to the study of psychopathology in the general population.

Child Development Disorders, Pervasive↗
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↗