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Systematic observation of classroom behavior of retarded and autistic preschool children.

Two groups of 6 children, previously diagnosed as autistic and mentally retarded, were observed for seven 20-minute sessions. The following environmental parameters were manipulated: teacher-to-child ratio, presence of food reinforcement, and skill area being presented. Behavior under observation fell into 3 classes: (a) adaptive performance (percentage response and percentage correct), (b) attention, and (c) maladaptive behavior. Results suggested that (a) food reinforcement and the 1:1 teacher-to-child ratio may not generally enhance adaptive performance but may have an effect upon attention and tantrum behavior; (b) attention to task is more predictive of adaptive behavior than attention to teacher; and (c) interactions were generally lacking between the above parameters and diagnostic group, while level of functioning did show such interactions. The present results support the practice of individual behavioral assessment of autistic and retarded children. The present procedure, coupled with statistical analysis for individual subjects, may provide educational prescriptions for individual children.

Aptitude↗

Diagnosis and evaluation of pervasive developmental disorders.

Accurate diagnosis and appropriate treatment of pervasive developmental disorders (PDDs), including autistic disorder, Asperger's disorder, and pervasive developmental disorder not otherwise specified, are necessary to ensure the best possible outcomes for children with these disorders. In the past, it was not uncommon for children with PDDs to wait several years from the time of parental recognition of developmental delay to the determination of the correct diagnosis and initiation of treatment. Increased awareness of PDDs and the availability of better assessment tools have improved the detection of these conditions in children. A wide variety of standardized diagnostic checklists, interviews, and observational measures are available to assist the clinician in making an accurate PDD diagnosis. A comprehensive evaluation also establishes a baseline of adaptive functioning and problematic behavior, which is essential for subsequent assessment of progress. This article discusses the differential diagnosis and evaluation of PDDs, focusing on the various assessment tools. The elements of a contemporary diagnostic evaluation and behavioral assessment are presented. The application of discretionary evaluations for special situations are also introduced.

Adult↗

Juvenile firesetting: a unique syndrome or an advanced level of antisocial behavior?

The current study examined whether juvenile firesetting represents a unique syndrome or an advanced level of antisocial behavior. Thirty-six incarcerated juvenile delinquents, all of whom met criteria for a diagnosis of Conduct Disorder, served as subjects and were categorized into one of three groups: firesetters, non-firesetters but comparable to firesetters in number of conduct disorder symptoms, and non-firesetters who displayed fewer conduct disorder symptoms than the other two groups. Caregivers completed the Child Behavior Checklist on the youth to provide information about the severity and range of psychopathology. The results indicated that firesetters and non-firesetters who had a comparable number of symptoms did not differ from one another on the CBCL subscales of adolescent psychopathology but both differed from the group with fewer symptoms. These results suggest that firesetting does represent an advanced level of antisocial behavior, but that firesetting is not a unique syndrome, at least not in terms of caretakers' perceptions of the youths' problematic behavior. Implications for treatment of firesetters are presented.

Adolescent↗

The Behavioral Summarized Evaluation: validity and reliability of a scale for the assessment of autistic behaviors.

The Behavioral Summarized Evaluation (BSE), is a 20-item paper-and-pencil rating scale specifically designed for the measurement of behavioral parameters which could be related to biological data in autistic children involved in educational programs, neurophysiological studies, and therapeutic trials. The development of the scale, the validity, and reliability studies are presented in this paper. The results suggest that the BSE is an acceptable tool for the assessment of autistic behaviors, easy to handle, and accessible to both professionals and paraprofessionals of the medico-educative staff. It is a useful addition to the bioclinical researcher's evaluation battery for bioclinical and therapeutic studies. However, more work is suggested to further investigate the psychometric properties of this behavior assessment instrument.

Adolescent↗

[Behavioral patterns of autistic children during infancy].

OBJECTIVE: The present study investigated the behavioral patterns of autistic children during infancy to provide clues for early identification of childhood autism. METHODS: The abnormal behaviors of 30 children with autism and 26 children with other developmental disorders in infancy were investigated. RESULTS: The children with autism presented a series of abnormal behaviors, including no social smile, no eye contact and no respond to own name, and joint attention deficiency, which were distinguished from the children with other developmental disorders. The imitation and attachment behaviors were significantly different between the two groups. Repetitive motor actions and interest peculiarity were only seen in children with autism. CONCLUSIONS: The children with autism may present a series of abnormal behaviors as early as in infancy. The abnormal behaviors facilitate early diagnosis of autism.

Autistic Disorder↗

Community studies on adolescent substance use, abuse, or dependence and psychiatric comorbidity.

A literature review on community studies of adolescent substance use, abuse, or dependence (SU/AID) and psychiatric comorbidity yielded 22 articles from 15 studies with information on rates, specificity, timing, and differential patterns of comorbidity by gender, race/ethnicity, and other factors. Results revealed that 60% of youths with SU/A/D had a comorbid diagnosis, and conduct disorder (CD) and oppositional defiant disorder (not attention-deficit/hyperactivity disorder) were most commonly associated with SU/A/D, followed by depression. Child psychopathology (particularly CD) was associated with early onset of substance use and abuse in later adolescence. The authors suggest that available data relevant to SU/A/D and psychiatric comorbidity can be used to better address such questions.

Adolescent↗

Analysis of a five-and-a-half-year-old girl: indications for a dyadicphallic phase of development.

The presentation of the analysis of a five-and-a-half-year-old girl highlighted a personality configuration with multiple fixation points (some preoedipal) organized around an early phallic structure. The sequence of this analysis underscored characteristics of the early phallic phase of development as a transitional phase between dyadic and triadic and preoedipal and oedipal levels. The term dyadic-phallic was introduced to emphasize the special feature of this phase. A phallic drive-organization is on the ascendancy while object constancy is not yet sufficiently consolidated to permit the shift from dyadic to triadic patterns and the accompanying consolidation and differentiation of basic ego functions. Preoedipal fears of separation, loss, and fragmentation exist alongside phallic wishes and fears of moving ahead into a full oedipal configuration. Character traits embodying phallic-narcissistic styles of relating to other and self conceal these fears and hold together an otherwise fragile personality organization. It is proposed that this level of development may serve as an organizing point for many character disorders which embody earlier fixation points, including many of the narcissistic character disorders.

Child Behavior Disorders↗

Risperidone monotherapy in preschool children with pervasive developmental disorders.

The aim of this preliminary study was to examine the short-term efficacy and safety of the atypical antipsychotic risperidone in preschool autistic children. The sample consisted of 10 subjects (7 males and 3 females) aged 3 9/12 to 6 6/12 years (mean age 4.7 years). A 16-week open-label trial with risperidone monotherapy was initiated at a starting dose of 0.25 mg daily and was increased to a maximum dose of 0.50 mg (0.027 mg/kg daily). Outcome measures were the Childhood Autism Rating Scale, the Children's Psychiatric Rating Scale, Clinical Global Impression (improvement score), and the Children's Global Assessment of Functioning. Two subjects did not complete the trial because of side effects (tachycardia and flushes, fever and hyporexia). After the 16-week treatment, data from the eight children who completed the trial indicated a modest improvement in the Childhood Autism Rating Scale total score, Children's Psychiatric Rating Scale total score, and Children's Global Assessment of Functioning. According to the Clinical Global Impression, the global improvement score for four subjects was much improved or very much improved; the score for the other four children was minimally improved. None of the children exhibited behavioral deterioration. The side effects in the eight children were not severe.

Antipsychotic Agents↗

Pathogenetic considerations of pica in lead poisoning.

An important factor associated with lead poisoning in children is the habit of eating non-food substances, a condition termed pica. In search for underlying mechanisms involved in the pathogenesis of pica, this investigation presents evidence in support of the hypothesis that in many families failure of normal mother-child interaction, paternal deprivation, culturally dependent maternal oral interests and significant stress factors in the home where abundant lead-containing material is available are etiologically related to the development of pica in lead poisoning. Other factors, which have been thought to be associated with pica, are nutritional deficiencies and maladaptive behavior patterns. A multifocal treatment approach is considered to be most effective.

Child↗

Are children who steal different from those who are aggressive?

Data on 2181 children referred to a child psychiatry service were analyzed to determine if there were specific correlates for aggressive behavior and for stealing behavior. Compared with stealers, aggressive children tended to be younger and more immature males, and to come from stressed families with a history of mental illness. These findings support the notion that there are biological and reactive components to aggression.

Adolescent↗

Behavioral consequences of congenital rubella.

Psychiatric and behavioral consequences of congenital rubella are reported for 243 children studies during the preschool period, and for 205 of these who were re-examined at ages 8 to 9. At preschool 37% were retarded, with the skew toward severe and profound; 15% had reactive behavior disorder and 7% had autism. At school age retardation diminished to 25%, but neurotic problems and behavioral pathology due to neurologic damage both increased. There were two remissions and three new instances of autism.

Autistic Disorder↗

Testing for behavioral contagion in a case-control design.

'Behavioral contagion' refers to an increased tendency for a behavior to be performed when socially related persons have already performed it. So understood, behavioral contagion may be involved in criminality, conduct disorder, drug abuse, suicide, and teenage pregnancy. In a recent paper we showed that contagion, when present, generates highly distinctive result patterns in survey data. These patterns allow one to infer that contagion is present even though it has not been directly observed. The present paper extends this approach to case-control designs, where, it will be shown, contagion has equally distinctive but different consequences. The analysis is illustrated with a Canadian study of conduct disorder and further evidence is presented that this condition is contagious. Limitations of the approach and alternative interpretations of results are discussed.

Adolescent↗

An adoption study of drug abuse/dependency in females.

In a sample of 102 women who had been adopted at birth, drug abuse/dependency was found by log-linear analyses to have a major pathway of genetic etiology that started with a biologic parent with antisocial personality and led to an adoptee with conduct disorder and then through aggressivity to drug abuse/dependency, as well as from conduct disorder directly to drug abuse. This result was similar to findings from a male sample collected from the same agencies and at the same time, wherein antisocial biologic parents produced aggressive and conduct-disordered off-spring, who in turn became drug abusers/dependents as adults. Results are compatible with family studies demonstrating that female drug abusers stem from deviant families and themselves demonstrate socially deviant behavior early in life. The present study shows that one element of familial factors is genetic, and that, in addition, the family environment directly affects behavior (aggressivity) that leads to drug abuse/dependency.

Adolescent↗