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Results for “Child Behavior Disorders”

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PubMed2003

Imitation performance in toddlers with autism and those with other developmental disorders.

BACKGROUND: The present study sought to examine the specificity, developmental correlates, nature and pervasiveness of imitation deficits very early in the development of autism. METHODS: Subjects were 24 children with autism (mean age 34 months), 18 children with fragile X syndrome, 20 children with other developmental disorders, and 15 typically-developing children. Tasks included manual, oral-facial, and object oriented imitations, developmental measures, joint attention ability, and motor abilities. RESULTS: Children with autism were found to be significantly more impaired in overall imitation abilities, oral-facial imitation, and imitations of actions on objects than children in all of the other groups. Imitation skills of young children with fragile X syndrome were strongly influenced by the absence or presence of symptoms of autism. For children with autism, imitation skills were strongly correlated with autistic symptoms and joint attention, even when controlling for developmental level. For comparison groups, imitation was related to other developmental abilities including play, language, and visual spatial skills. Neither motor functioning nor social responsivity accounted for a significant amount of variance in imitation scores, when controlling for overall developmental level, which accounted for much of the variation in imitation ability. CONCLUSIONS: Simple imitation skills were differentially impaired in young children with autism, and lack of social cooperation did not account for their poor performance. In autism, imitation skills clustered with dyadic and triadic social interactions and overall developmental level, but were not related to play or language development. For comparison children, all these areas were inter-related. Hypotheses about a specific dyspraxic deficit underlying the imitation performance in autism were not supported.

Apraxias↗
PubMed2000

The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism.

The Autism Diagnostic Observation Schedule-Generic (ADOS-G) is a semistructured, standardized assessment of social interaction, communication, play, and imaginative use of materials for individuals suspected of having autism spectrum disorders. The observational schedule consists of four 30-minute modules, each designed to be administered to different individuals according to their level of expressive language. Psychometric data are presented for 223 children and adults with Autistic Disorder (autism), Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS) or nonspectrum diagnoses. Within each module, diagnostic groups were equivalent on expressive language level. Results indicate substantial interrater and test-retest reliability for individual items, excellent interrater reliability within domains and excellent internal consistency. Comparisons of means indicated consistent differentiation of autism and PDDNOS from nonspectrum individuals, with some, but less consistent, differentiation of autism from PDDNOS. A priori operationalization of DSM-IV/ICD-10 criteria, factor analyses, and ROC curves were used to generate diagnostic algorithms with thresholds set for autism and broader autism spectrum/PDD. Algorithm sensitivities and specificities for autism and PDDNOS relative to nonspectrum disorders were excellent, with moderate differentiation of autism from PDDNOS.

Autistic Disorder↗
PubMed2006

Clinical characteristics of bipolar disorder in very young children.

BACKGROUND: Clinical information about bipolar disorder (BPD) in preschool-age (3-7 years old) children is extremely limited. This study examined clinical presentations, applicability of the DSM-IV diagnostic criteria, comorbidity, recovery and relapse rates, as well as some treatment strategies used in the management of BPD in preschoolers. METHODS: The charts of 26 outpatient children, ages 3-7, refereed to a child psychiatry outpatient clinic with mood and behavioral symptoms, were retrospectively reviewed. RESULTS: The majority of the patients were referred with the tentative diagnosis of ADHD but the most common diagnoses made by child and adolescent psychiatrists at the time of initial evaluation were BPD NOS (61.5%), followed by BPD I (26.9%), and mood disorder NOS (23.1%). Thirty-eight percent of the patients had one or more comorbid diagnoses. The most common presenting symptoms were irritability (84.6%) and aggression (88.5%). The most widely prescribed class of medications after diagnosis in the clinic was atypical antipsychotics and mood stabilizers. Twenty-six percent of the patients were treated with a combination of atypical antipsychotics and mood stabilizers. LIMITATIONS: Retrospective design; small sample size; lack of a comparison group. CONCLUSIONS: The course of BPD with onset in preschool years is complicated with high recovery and relapse rates. The questions of development of age-appropriate diagnostic criteria, long-term prognosis and treatment strategies used in this population require further intensive investigation.

Aggression↗
PubMed1996

Psychiatric diagnoses in the child and adolescent members of extended families identified through adult bipolar affective disorder probands.

OBJECTIVE: To investigate the type and distribution of psychiatric disorders in the child and adolescent members of extended pedigrees identified through bipolar probands. METHOD: The child and adolescent offspring (24 male, 26 female, aged 6 to 17 years) and the adult parents (60) of 14 bipolar pedigrees ascertained for the National Institutes of Mental Health Genetics Initiative Study of Bipolar Affective Disorder were personally assessed using structured psychiatric interviews. A parent was also interviewed about each child or adolescent offspring. RESULTS: Twelve of the 50 interviewed offspring received a lifetime DSM-III-R diagnosis of an affective disorder. This included six cases of bipolar disorder, five cases of major depressive disorder, and one case of dysthymia. Eight of the offspring who received an affective disorder diagnosis also qualified for an anxiety disorder (four), a disruptive behavior disorder (two), or both (two). Offspring who had a parent with an affective disorder had a 5.1-fold higher risk for receiving an affective disorder diagnosis than did offspring with healthy parents. CONCLUSIONS: In a consecutive series of families identified through a proband with bipolar disorder, there were significant increases in the prevalence of affective disorder diagnoses in the child and adolescent offspring. The distribution of illness in offspring was compatible with the presence of important genetic factors which contribute to early-onset affective illness.

Adolescent↗
PubMed2006

Parental beliefs about autism: implications for the treating physician.

This study investigated parental beliefs about the etiology, diagnosis, and treatment of autism spectrum disorders. Sixty-two families of affected children completed a questionnaire asking when the parent first noticed developmental or behavioral problems, when they were told the diagnosis, how confident they were about the ability of their child's physician to recognize autism, whether they believed anything specific might have caused their child's autism, and what medications and complementary or alternative therapies they had tried. Two-thirds of parents suspected a specific cause, and three-quarters questioned their physician's ability. Parents who perceived a greater delay in diagnosis or who had tried more different therapies both tended to have less confidence in their physician (p = 0.20 and p = 0.07, respectively). Physicians should inquire about parental beliefs concerning etiology, learn what treatments the children are receiving, perform screening at the 18 month visit, and make referrals for further evaluation as soon as a child begins to exhibit signs suggestive of autism.

Adolescent↗
PubMed1992

Young children of affectively ill parents: a longitudinal study of psychosocial development.

The course of social-emotional development of young children of affectively ill and well parents was assessed. The families were classified by mother's diagnosis: bipolar illness (N = 22), unipolar depression (N = 41), and normal (N = 37). Father's diagnosis also was obtained. Pairs of siblings were studied; the younger was between 1 1/2 and 3 1/2 years and the older between 5 and 8 years when the study began. They were seen again 3 years later. Psychiatric assessment and mother's report were used to evaluate children's disruptive behavior, anxiety, and depressive characteristics. The frequency of problem-level behavior changed over time in relation to mother's diagnosis. By middle and late childhood, significantly more children of affectively ill than well mothers had depressive and disruptive problems and multiple behavior problems. Offspring of unipolar mothers developed problems earlier and both siblings were more likely to have behavior problems.

Anxiety Disorders↗
PubMed2003

Parental identification of early behavioural abnormalities in children with autistic disorder.

The aim of the study was to identify early behavioural abnormalities in children later diagnosed with autistic disorder. Accurate identification of such deficits has implications for early diagnosis, intervention and prognosis. The parents of 153 children with autistic disorder completed a questionnaire asking them to describe early childhood behaviours of concern and to recall the age of onset. Core deficit-linked behaviours were then identified and the ontogeny of their development was noted. Behaviour categories were: (1) gross motor difficulties, (2) social awareness and play deficits, (3) language and communication difficulties, and (4) unusual preoccupations. The findings supported the notion that the nature and prevalence of these deficits depend on age. Consistent with past research, there was a significant interval between parents first noticing abnormalities and the making of a definitive diagnosis. The implications for this delay are discussed.

Adolescent↗
PubMed1994

The assessment of individual differences between young children with a pervasive developmental disorder by means of behaviour scales which are derived from direct observation.

Data obtained by direct observation of 112 3-6-year-old normal children and 31 children with a pervasive developmental disorder aged 3-6 were used to construct behaviour scales by means of simultaneous component analysis. This is a technique for finding behaviour clusters (components) common to different groups by weighting the variables such that the resulting components maximize variance accounted for when summed over the groups (Milsap & Meredith, 1988, Psychometrika, 53, 123-134; Berge & Kiers, 1990, Nederlands Tijdschrift voor de Psychologie, 45, 221-226). An evaluation of the component structure that was found is given for both groups. Results show uncorrelated components for the normal group, while some of the same components are intercorrelated in the clinical group. Scales were constructed which are shown to have discriminative value with respect to subgroups within the group of patients.

Autistic Disorder↗
PubMed2006

[An effect of long-term cerebrolysin therapy in combination with neuroleptics on behavioral and cognitive disturbances in endogenous childhood autism].

An open prospective clinical study included 25 patients with childhood autism aged from 3 to 8 years (mean age 5 years 11 months). Patients received 2 therapeutic courses (15 intramuscular Cerebrolysin injections of 1.0 ml every other day per course) with 2 months interval and basic antipsychotic therapy using typical neuroleptics in age-adjusted dosages. The duration of the study was 180 days. Significant or very significant improvement was achieved after the 1st Cerebrolysin course in 38% patients, after the 2nd course in more than 50% and to the end of the follow-up (180th day) in 71% of patients. There were no cases of deterioration during the trial. The autism severity as measured by the CARS scale consistently decreased from the day 0 to the day 180--from 37.7 to 32.6 scores, respectively (p < 0.001) in all assessments as compared with the baseline. To the end of the study, the patients demonstrated a significant decrease in mental retardation by 0.2 years. A statistically significant improvement was achieved in cognitive activity, attention during task performing as well as in self-service (by 0.3 years), receptive and expressive speech, cognitive performance and perception (by 0.2 years), fine motor function (by 0.1 years). The combined therapy comprising neuroleptics and Cerebrolysin double course can be recommended for correction of behavioral disorders and cognitive dysfunction in patients with mild moderate and moderate/severe autism.

Amino Acids↗
PubMed2004

[How effective are interventions in children and adolescents with antisocial behavior? A utilization study].

OBJECTIVE: Anti-social behavior in childhood and adolescence represents a frequent behavior disorder in this age group and its prognosis is predominantly unfavourable. The purpose of this study was to analyze the outcome and predictors of outpatients and inpatients with conduct disorders and internalizing disorders. METHOD: We compared a 10 year follow-up history of in- and outpatients with conduct disorders and internalizing disorders. The sample of patients with conduct disorders was divided into three groups ("I": F90.1; "E": F91.2, F92; "D": F91.1, F91.3). The outcome was defined as an improvement of psychosocial functioning (SGKJ). Statistical analysis consisted of Fisher exact test and logistical regression. RESULTS: Our findings showed the best results in patients with the ICD 10 diagnosis F90.1. Inpatient treatment was superior to outpatient treatment. Cooperation of parents and children, severeness of disease, psychosocial risk factors and pharmacotherapy were found to be the most important predictors. CONCLUSIONS: Effectiveness of an outpatient treatment of children and adolescents with conduct disorders can be increased by training of parents, home treatment or pharmacotherapy.

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↗
PubMed2004

Measuring informant discrepancies in clinical child research.

Discrepancies among informants' ratings of child psychopathology have important implications for diagnosis, assessment, and treatment. Typically, parents and children complete measures (e.g., self-report checklists, diagnostic instruments) to assess child dysfunction. Ratings gathered from these sources reveal relatively little agreement on the nature and extent of the child's social, emotional, and behavioral problems. This article reviews and illustrates the most frequently used methods of measuring informant discrepancies in the clinical child literature (i.e., raw difference, standardized difference, and residual difference scores) and outlines key considerations to influence their selection. The authors conclude that frequently used methods of measuring informant discrepancies are not interchangeable and recommend that future investigations examining informant discrepancies in clinical child research use the standardized difference score as their measure of informant discrepancies.

Adolescent↗
PubMed2002

Chromosome 22q11 deletion syndrome (CATCH 22): neuropsychiatric and neuropsychological aspects.

Twenty children and young adults (age range 5 to 33 years, 12 females and eight males) with genetically confirmed 22q11 deletion syndrome (CATCH 22: Cardiac anomaly, Anomalous face, Thymus hypoplasia/aplasia, Cleft palate, and Hypocalcaemia), recruited from a large ongoing study, were given comprehensive assessments with a view to determining the pattern of neuropsychiatric and neuropsychological deficits thought to be part of the syndrome in many cases. IQ ranged between 46 and 100 with a mean score of 70. Half the group had an IQ <70. In 13 individuals, attention-deficit-hyperactivity disorder (ADHD), mainly inattentive or combined type in most cases, and/or autism spectrum problems were diagnosed. Many participants, even among those who had an IQ within the normal range and had neither ADHD nor autistic spectrum problems, showed a characteristic and pronounced behavioural profile with low mental energy, initiation difficulties, deficits in sustained attention, and social interaction (often augmented by limited facial expression and communication and speech problems).

Abnormalities, Multiple↗