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PubMed2006

Exploratory and confirmatory factor analyses of the pervasive developmental disorders rating scale for young children with autistic disorder.

In this study, the authors examined the construct validity of the Pervasive Developmental Disorder Rating Scale (PDDRS; R. C. Eaves, 1993), which is a screening instrument used to identify individuals with autistic disorder and other pervasive developmental disorders. The PDDRS is purported to measure 3 factors--arousal, affect, and cognition-that collectively make up the construct of autism. Using scores from 199 children (aged 1-6 years) diagnosed with autistic disorder, the authors submitted data to exploratory and confirmatory factor analyses. In the 1st series of analyses, the authors analyzed a user-specified 3-factor solution using principal axis factor analysis with a promax rotation to evaluate the assertion of a correlated 3-factor structure. Next, the authors analyzed 1-factor and 2-factor solutions to determine if they provided a better factor structure for the data. In the 2nd series, the authors conducted confirmatory factor analyses, which compared the theorized hierarchical 2nd-order factor model with 5 plausible competing models. The results of the exploratory analyses supported the 3-factor solution. With the confirmatory analyses, the 2nd-order factor model provided the best fit for the data. The exploratory and confirmatory analyses supported the theoretical assumptions undergirding the development of the PDDRS. The authors discuss theoretical implications, practical implications, and areas for further research.

Affect↗
PubMed2004

Olanzapine in the treatment of pervasive developmental disorders: a case series analysis.

Controlling the symptoms that are characteristic of patients with pervasive developmental disorders is often challenging. We report on the safety and efficacy of olanzapine in the treatment of 7 patients with pervasive developmental disorders. The patients were all male and ranged in age from 8 to 52 years. They received olanzapine doses of 5-10 mg/d along with their various other drug regimens. Patients were monitored and evaluated for a mean duration of 17.7 (range 12-26) months while on olanzapine therapy. Very few side effects were observed during treatment. All patients showed clinically significant improvement on the Clinical Global Impressions scale, as well as an improved score as measured by the Global Assessment of Functioning scale. Our observations support the use of long-term olanzapine therapy for symptom control in patients with pervasive developmental disorders.

Adolescent↗
PubMed2003

Developmental disorders of vision.

This review of developmental disorders of vision focuses on only a few of the many disorders that disrupt visual development. Given the enormity of the human visual system in the primate brain and complexity of visual development, however, there are likely hundreds or thousands of types of disorders affecting high-level vision. The rapid progress seen in developmental dyslexia and WMS demonstrates the possibilities and difficulties inherent in researching such disorders, and the authors hope that similar progress will be made for congenital prosopagnosia and other disorders in the near future.

Brain↗
PubMed1997

Risperidone treatment of children and adolescents with pervasive developmental disorders: a prospective open-label study.

OBJECTIVE: To investigate the short-term safety and efficacy of risperidone in the treatment of children and adolescents with pervasive developmental disorders. METHOD: This was a 12-week, prospective, systematic, open-label trial that included 18 subjects (15 boys and 3 girls) with a mean age of 10.2 +/- 3.7 years. The sample included 11 subjects with autistic disorder, 3 with Asperger's disorder, 1 with childhood disintegrative disorder, and 3 with pervasive developmental disorder not otherwise specified. Fourteen subjects had comorbid mental retardation. Behavioral ratings were obtained during two baseline visits and again after 12 weeks of risperidone treatment. RESULTS: The optimal dose of risperidone for the 18 subjects was 1.8 +/- 1.0 mg/day. On the basis of the global improvement item of the Clinical Global Impression Scale, 12 of 18 subjects were considered responders. Significant improvement was seen in measures of interfering repetitive behavior, aggression and impulsivity, and some elements of impaired social relatedness. The most common side effect was weight gain (range 10 to 35 lb). CONCLUSIONS: These preliminary results suggest that risperidone may be effective for improving interfering behavioral symptoms in some children and adolescents with pervasive developmental disorders. Double-blind, placebo-controlled studies are needed before definitive statements of safety and efficacy can be made.

Adolescent↗
PubMed2004

Brief report: parental reporting of regression in children with pervasive developmental disorders.

Information on age and nature of the onset of autism and other developmental disorders was obtained through review of parent completed developmental history; in addition information on the child's early development, diagnostic information, and information on parent characteristics was also obtained. In this relatively large series of cases the parents of children with autism were more likely than parents of children with other developmental disorders to report possible loss of developmental skills. However, the question of actual skill loss was complicated since in some cases parents also had reported even earlier developmental delays or a pattern more of developmental stagnation than clear loss of abilities. Only a few children exhibited a clear and unequivocal loss of developmental skills.

Child↗
PubMed2005

Systematic review of randomized controlled trials of atypical antipsychotics and selective serotonin reuptake inhibitors for behavioural problems associated with pervasive developmental disorders.

A systematic review of randomized controlled trials of the use of atypical antipsychotics and selective serotonin reuptake inhibitors in the treatment of behavioural problems associated with pervasive developmental disorders is reported. A search through both published and unpublished literature, including contacting drug companies and known experts in the field was undertaken. Six trials met the criteria for inclusion in the review. They largely suffer from methodological weaknesses; only two trials had satisfactory methodological quality. The heterogeneity in outcome measurements prevented from conducting a meta-analysis. There is yet no coherent body of data concerning the effects of these medications across all sub-classifications of pervasive developmental disorders, across all age categories, and concerning their medium- and long-term effects, and their effects on quality of life. Atypical antipsychotics and selective serotonin reuptake inhibitors may be of benefit for behavioural problems associated with pervasive developmental disorders. Risperidone has been the best studied among these medications. Atypical antipsychotics appear to have a low risk of extrapyramidal symptoms during short-term treatment. The reviewed trials cannot provide data on the use of selective serotonin reuptake inhibitors in the treatment of children with pervasive developmental disorders. No firm conclusions for clinical practice can be drawn. Larger, well-conducted randomized controlled trials with long-term follow-up are needed.

Adolescent↗
PubMed2006

Neuropsychological effects of risperidone in children with pervasive developmental disorders: a blinded discontinuation study.

OBJECTIVE: Little is known about the neuropsychological effects of risperidone in children with pervasive developmental disorders. METHOD: Twenty-four children (aged 5-17 years) with pervasive developmental disorders and co-morbid disruptive behavior who responded favorably to open-label treatment with risperidone as part of a previously described controlled discontinuation study completed two different computerized attention tasks at baseline, weeks 4, 8, and 24 of open-label treatment, and, at 8 weeks after random assignment to either placebo or risperidone. The primary efficacy measures were response latencies to visually presented stimuli requiring two different types of attention-controlled processing, i.e., focused and divided attention. RESULTS: About half of the clinical responders did not produce valid performance measures. These could be shown to be of younger mental age and less adaptive as measured by the Vineland Behavior Scales. For the valid task performers divided attention (serial search in working memory) was shown to regress in the placebo group (n = 7), while in the risperidone group (n = 7) there was further improvement. No such group difference was found for focused attention. CONCLUSIONS: The study suggests a beneficial effect of risperidone after several months of treatment, enhancing divided attention in children with pervasive developmental disorders.

Adolescent↗
PubMed2004

The incidence and prevalence of pervasive developmental disorders: a Danish population-based study.

BACKGROUND: Based on prevalence studies and the few incidence studies of pervasive developmental disorders (PDDs) the prevalence and incidence of these disorders have been claimed to be increasing. METHOD: The annual and age-specific prevalence and incidence rates of childhood autism, atypical autism, Asperger's disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS) in Denmark during the period 1971--2000 in children younger than 10 years were estimated using data from the Danish Psychiatric Central Register. RESULTS: A total of 2.4 million children younger than 10 years were followed and 2061 cases with the PDDs studied were identified. Generally, the prevalence and incidence rates of the PDDs studied were stable until the early 1990s after which an increase in the occurrence of all disorders was seen, until 2000. The annual incidence rate per 10000 children younger than 10 years was 2.0 for childhood autism, 0.7 for atypical autism, 1.4 for Asperger's disorder, and 3.0 for PDD-NOS in 2000. We calculated a 'corrected' prevalence of childhood autism at 11.8, atypical autism at 3.3, Asperger's disorder at 4.7, and PDD-NOS at 14.6 per 10,000 children younger than 10 years on 1 January 2001. CONCLUSIONS: We found that the estimated prevalences of the PDDs studied were probably underestimated. Furthermore, the increasing prevalence and incidence rates during the 1990s may well be explained by changes in the registration procedures and more awareness of the disorders, although a true increase in the incidence cannot be ruled out.

Age Factors↗
PubMed2000

A prevalence methodology for mental illness and developmental disorders in rural and frontier settings.

A prevalence study methodology developed for use in rural and frontier settings is described. The general method was developed over a 15 year period and has been successfully adapted and used in studies of 14 different childhood onset developmental disorders. Subjects were the 168,000 school aged children from North Dakota who were first surveyed for cases of autism--pervasive developmental disorders in 1985 and 1986. The results of the prevalence study were compared with the results of a 12-year ongoing surveillance of the cohort. The 12-year ongoing surveillance identified one case missed by the original prevalence study. Thus the original prevalence study methodology identified 98% of the cases of autism-pervasive developmental disorder in the population. This methodology may also be useful for studies of other developmental disorders in rural and frontier settings.

Adolescent↗
PubMed2003

Cerebellar involvement in clumsiness and other developmental disorders.

Cerebellar abnormalities have been linked to a number of developmental disorders. Much evidence is based on the analysis of high-resolution MRI scans. Imaging and behavioral studies have led researchers to consider functional contributions of the cerebellum beyond that associated with motor control. I review this literature, providing an analysis of different ways to consider the relation between cerebellar abnormalities and developmental disorders. Interestingly, although clumsiness is a problem of coordination, the contribution of cerebellar dysfunction to this developmental problem has received little attention. Select studies indicate that some clumsy children have difficulties on tasks requiring precise timing, similar to that observed in adult patients with cerebellar lesions. I suggest that the underlying neural bases of clumsiness are heterogeneous, with cerebellar dysfunction likely a major contributor for a subpopulation of such children.

Animals↗
PubMed2001

Effectiveness of N,N-dimethylglycine in autism and pervasive developmental disorder.

N,N-dimethylglycine, a dietary supplement, has been reported to be beneficial in children with autism and pervasive developmental disorder. We examined the effectiveness of dimethylglycine in children with autism and pervasive developmental disorder in a double-blind, placebo-controlled study. Thirty-seven children between 3 and 11 years of age with a diagnosis of autism and/or pervasive developmental disorder were gender and age matched and randomly assigned to receive either placebo or dimethylglycine for 4 weeks. All children were assessed before and after treatment on two behavioral measures, the Vineland Maladaptive Behavior Domain and the Aberrant Behavior Checklist. Standardized neurologic examinations before and after treatment on 33 children showed no change. An overall improvement on all behavioral measures was observed for both the placebo and the dimethylglycine groups. However, the improvement among the children who received dimethylglycine was not statistically different from the improvement observed among the children who received the placebo. The children who participated in this study were a heterogeneous group, and their apparent responses to the dimethylglycine varied. Some children appeared to respond positively to the dimethylglycine, and there was a smaller proportion of negative changes in the dimethylglycine group, but the quantitative changes in the dimethylglycine behavioral assessments were not significantly different from what was observed among children who received placebo.

Autistic Disorder↗
PubMed2006

[Study of the kid-kINDL questionnaire scores for children with developmental disorders in normal classes and their parents].

The KINDL-questionnaire is able to measure degrees of health and adaptability in relation to quality of life (QOL) in children. The questionnaire can be completed by children, adolescents, and their parents (parent-version). We had translated Kid-KINDL questionnaire into Japanese as Questionnaire for Measuring QOL in Japanese Elementary School Children, and reported their reliability and validity. This study investigates Japanese elementary school version of the Kid-KINDL questionnaire scores consisting of 6 dimensions (4 items each;total score, 100) for children with developmental disorders without mental retardation including high-functioned pervasive developmental disorder, attention deficit/hyperactivity disorder and learning disorder, and the parent-version scores for their mothers. Twenty individuals in normal class and their mothers participated after informed consents were obtained. Their total QOL scores were significantly lower than those in control group. Four of 6 dimensions consisting of emotional well-being, self-esteem, family, friends and school had significantly lower points. Their mothers' points in total QOL scores and all dimensions except for family dimension were significantly lower than those in control group. In comparison of scores between children with mild developmental disorders and their mothers, children estimated lower in self-esteem and family dimensions instead mother estimated lower in health, emotional well-being and school dimensions. There was no difference in total scores between them. Children with mild developmental disorders and their mothers estimate lower points of QOL scores than those of the normal control group. There are different perceptions in 5 of 6 dimensions between the children and their mothers.

Attention Deficit Disorder with Hyperactivity↗
PubMed1997

Bioclinical profiles of autism and other developmental disorders using a multivariate statistical approach.

To study the relationships between clinical and biological data that are necessary for physiopathological analysis in the field of developmental disorders, we developed a quantified grouping system, based on four developmental assessment parameters. Parallel with this clinical research, we developed electrophysiological procedures adapted to the pathology of autism. In this paper, we report the utilization of an original multivariate descriptive statistical approach (correspondence analysis followed by cluster analysis) that allowed us to identify different bioclinical profiles using these clinical and electrophysiological data conjointly. These profiles are believed to be evidence for different underlying cerebral dysfunctions. This procedure proved effective in identifying two main bioclinical dimensions in a population of 145 developmentally disordered children. These dimensions reflect the association of intellectual impairment and centroparietal electrophysiological reactivity on the one hand, and autistic behavior and temporal electrophysiological reactivity on the other. This study, performed on a large population of children using objective methods of data analysis, provides validation of numerous multidisciplinary studies of autism and other developmental disorders carried out on small samples of children.

Autistic Disorder↗
PubMed1999

Autism and the pervasive developmental disorders.

Our understanding of childhood autism and the related pervasive developmental disorders continues to advance in many areas. Nevertheless, the heterogeneity of phenotypic expression presents many challenges, not least to efforts to ascertain the prevalence of the disorders. There is now wide agreement on, and reliable application of, the diagnostic criteria for childhood autism, but there is less agreement on and less reliable application of the criteria for the related disorders atypical autism, pervasive developmental disorder-unspecified and Asperger's syndrome. Evidence about genetic associations indicates that several genes are involved in creating susceptibility to the disorder, and the first steps to identify susceptibility loci have begun. Neuroanatomical models have yet to receive consistent support but early signs of promising advances have been made in pharmacological interventions, and adequate evaluation of behavioural intervention programmes is now underway.

Autistic Disorder↗
PubMed1990

Pervasive developmental disorder in monozygotic twins.

Monozygotic twin brothers were diagnosed as having pervasive developmental disorder, not otherwise specified (DSM-III-R). They show different levels of cognitive and behavioral impairment, consistent with a greater number of suboptimal pre-, peri-, and postnatal factors present in one of the twins. This case study lends support to the hypothesis that genetic factors are of importance in the expression of a pervasive developmental disorder, but that degree of developmental delay, its severity, and certain clinical features may be determined by nongenetic suboptimal pre-, peri-, and postnatal events.

Autistic Disorder↗
PubMedDate not supplied

MMR vaccination and pervasive developmental disorders: a case-control study.

BACKGROUND: Concern that measles-mumps-rubella (MMR) vaccination might cause autism has led to a fall in vaccine coverage. We investigated whether MMR vaccination is associated with an increased risk of autism or other pervasive developmental disorders. METHODS: We did a matched case-control study using the UK General Practice Research Database. Cases were people born in 1973 or later who had first recorded diagnosis of pervasive developmental disorder while registered with a contributing general practice between 1987 and 2001. Controls were matched on age, sex, and general practice. FINDINGS: 1294 cases and 4469 controls were included. 1010 cases (78.1%) had MMR vaccination recorded before diagnosis, compared with 3671 controls (82.1%) before the age at which their matched case was diagnosed. After adjustment for age at joining the database, the odds ratio for association between MMR and pervasive developmental disorder was 0.86 (95% CI 0.68-1.09). Findings were similar when restricted to children with a diagnosis of autism, to those vaccinated with MMR before the third birthday, or to the period before media coverage of the hypothesis linking MMR with autism. INTERPRETATION: Our findings suggest that MMR vaccination is not associated with an increased risk of pervasive developmental disorders.

Asperger Syndrome↗
PubMed2007

Attachment in toddlers with autism and other developmental disorders.

Attachment was assessed in toddlers with Autistic Disorder (n=20), Pervasive Developmental Disorder (n=14), Mental Retardation (n=12), Language Development Disorder (n=16), and a non-clinical comparison group (n=18), using the Strange Situation Procedure (SSP). Children in the clinical groups were more often disorganized and less often securely attached. Severity of autism was associated with more attachment insecurity, and lower developmental level increased the chance for disorganized attachment. Attachment disorganization was related to increased heart rate during the SSP. Controlling for basal cortisol and developmental level, more autistic symptoms predicted lower cortisol responses to the SSP. The findings support the importance of disorganized attachment for children with autism.

Arousal↗
PubMed1995

Facial responsiveness to odours in normal and pervasively developmentally disordered children.

The facial responsiveness of 10 mutic children with pervasive developmental disorder (PDD) and 10 normal (N) children matched for sex and chronological age were covertly videotaped while presented with a set of odours contrasted in hedonic valence. Hedonic ratings of the stimuli were obtained both from the group of N subjects and a panel of adults. Two methods were used to measure facial responses in the same subjects. The first method consisted in an analysis of facial movements with the Facial Action Coding System. Results show that PDD and N subjects displayed distinct action units in response to unpleasant odours. PDD subjects typically displayed muscular actions indexing negative experience, while N subjects showed more smiles. With the second method, odour-elicited facial behaviour was rated by a panel of observers, who were asked to judge whether the subjects were exposed a pleasant, neutral or unpleasant smell. The facial responses to unpleasant odours were classified more accurately in PDD than in N subjects. These findings suggest a functional ability to sense the hedonics attached to odours, but a deficit of socialization of hedonic facial displays in developmentally disordered subjects.

Adolescent↗