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PubMed1991

Methods and measures of behavior in the diagnosis of autism and related disorders.

In the past 5 years, diagnostic schemes for autism and related psychiatric disorders have become increasingly sophisticated. However, within these diagnostic frameworks, no specific assessment procedures have been prescribed. On the other hand, work has continued in the development of empirically rooted instruments for the diagnosis and screening of autism and related disorders. The need for diagnostic methods and instruments that incorporate current diagnostic criteria, that use methods specifically aimed at gleaning information about the communicative and social deficits associated with autism, and that differentiate autism from related disorders is discussed. Two new instruments that attempt to fill this need, the Autism Diagnostic Interview and the Autism Diagnostic Observation Schedule, are briefly described.

Autistic Disorder↗
PubMed2004

Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) correspondence and conflicts with DSM-IV criteria in diagnosis of autism.

Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) are tests widely used for screening and diagnosis of autism. This study verified their correspondence and conflict with a diagnosis made with DSM-IV criteria. The sample consisted of 65 children, aged 18 months to 11 years. We found complete agreement between DSM-IV and CARS. We show that ABC does not distinguish individuals with autistic disorders from other cases of developmental disorders as well as CARS: the number of false negatives is high (46%) with ABC as opposed to 0% with CARS.

Autistic Disorder↗
PubMedDate not supplied

Early behavioral development in autistic children: the first 2 years of life through home movies.

OBJECTIVE: The main aim of the research is to study the early behavioral development in autistic children through home movies. METHODS: fifteen home movies, regarding the first 2 years of life of autistic children are compared with the home movies of 15 normal children. The films of the two groups were mixed and rated by blind ratings with the Grid for the Assessment of Normal Behavior in Infants and Toddlers. The grid is composed of 17 items grouped into three developmental areas: social competence, intersubjectivity and symbolic activity. For every area, we have identified specific children's behaviors. RESULTS: Significant differences between the two groups are found both in the range of age 0-6 for intersubjectivity, and in the ranges of age 6-12 and 18-24 for symbolic activity. CONCLUSIONS: The authors pose some hypotheses about an early-appearing impairment of intersubjectivity, the ability to represent other's state of mind, in subjects with autistic disorder.

Age Factors↗
PubMed1993

Prevalence and clinical significance of dilated Virchow-Robin spaces in childhood.

PURPOSE: To determine the prevalence and clinical significance of dilated Virchow-Robin spaces in pediatric patients. MATERIALS AND METHODS: Cranial magnetic resonance (MR) studies of 1,250 children who underwent imaging during 12 consecutive months were prospectively evaluated. RESULTS: Thirty-seven patients had prominent Virchow-Robin spaces. The most common indications for imaging in these patients were headache (n = 10), developmental delay (n = 8), and psychiatric problems (n = 7). Medical records revealed that 12 of the 37 patients had severe headaches, 17 had moderate or severe delay in development, and 18 had serious behavioral or psychiatric problems. An association was found between presence or absence of dilated Virchow-Robin spaces and presence or absence of developmental delay (odds ratio = 4.9; 95% confidence interval [CI] = 2.1, 11.1; P < .001), psychiatric problems (odds ratio = 12.6; 95% CI = 5.0, 31.8; P < .001), and headaches (odds ratio = 37; 95% CI = 14.7, 93.2; P < .001). CONCLUSION: There appears to be a correlation between functional neuropsychiatric disorders in children and the presence of Virchow-Robin spaces in the cerebral hemispheres at MR imaging.

Adolescent↗
PubMed1991

The relationship of interparental conflict and global marital adjustment to aggression, anxiety, and immaturity in aggressive and nonclinic children.

Although there is agreement that marital problems are associated either directly or indirectly with particular child behavior problems, there is disagreement about the types of marital conflict associated with these problems and the differential effects on boys and girls in clinic and nonclinic samples. We examined the relationships among mothers' ratings of marital adjustment, parenting disagreements, and three child problem factors (aggression, anxiety, and immaturity) after the child's age and family socioeconomic status were controlled. These relationships were compared with samples of boys and girls (3 to 8 years of age) from clinic and nonclinic populations, revealing that parenting disagreement predicted aggression in all groups and that both marital adjustment and parenting disagreement predicted anxiety in boys. Neither marital variable predicted immaturity. Possible reasons for the results (including methodological limitations of the present data) are discussed.

Aggression↗
PubMed2001

Conduct problems in Russian adolescents: the role of personality and parental rearing.

The purpose of the present study was 1) to assess the predictive value of conduct problems prior to the age of 12 for the severity of antisocial behaviour during adolescence, and 2) to investigate the relationships between personality traits/parental rearing and childhood conduct problems/teenage antisocial behaviour. A group of 193 delinquents was assessed by means of the Antisocial Behavior Checklist (ABC), the Retrospective Childhood Problems (RETROPROB), the Temperament and Character Inventory (TCI) and the EMBU questionnaire on parental rearing. The extreme groups of delinquents as defined by childhood conduct problems, differed significantly on the experience of a rejecting father and a self-directed character. Furthermore, some specific predictive patterns for current antisocial behaviour by childhood conduct disorder and both personality dimensions and parental rearing factors emerged. The findings are discussed in the light of the interactive nature of relations between personality and parental rearing in the development of antisocial behaviour among adolescents.

Adolescent↗
PubMed2004

Neurodevelopment and endocrine disruption.

In this article I explore the possibility that contaminants contribute to the increasing prevalence of attention deficit hyperactivity disorder, autism, and associated neurodevelopmental and behavioral problems in developed countries. I discuss the exquisite sensitivity of the embryo and fetus to thyroid disturbance and provide evidence of human in utero exposure to contaminants that can interfere with the thyroid. Because it may never be possible to link prenatal exposure to a specific chemical with neurodevelopmental damage in humans, I also present alternate models where associations have been made between exposure to specific chemicals or chemical classes and developmental difficulties in laboratory animals, wildlife, and humans.

Adult↗
PubMed1981

Consistency among commonly used procedures for assessment of abnormal children.

Administered the Stanford-Binet and/or its downward extension the Cattell Infant Intelligence Scale to 22 children in a school for severely behaviorally disordered boys and girls. Assessments also were made with the Vineland Social Maturity Scale and with a scale of language development. A subgroup of 17 children were assessed with Rimland's E-2 Scale, which is designed to assess the presence and degree of the condition of autism. Correlations among these commonly used assessment procedures are reported. Findings are discussed with respect to the construct validity of the tests and with respect to practical problems of implementation. Issues that concern the distinctiveness of specific classification dimensions and the heterogeneity of the syndrome of autism also are discussed.

Autistic Disorder↗
PubMed1994

Children with autistic spectrum disorder and a family history of affective disorder.

This paper compiles the clinical behavioral phenomenology of individuals with autistic spectrum disorder (ASD) with a family history of bipolar affective disorder (BPAD) or major depression and no identified neurological disorder, based on repeated clinical interviews during extended follow-up (ranging from six months to 21 (mean 3.9) years. Their pattern of affective and cognitive symptoms showed notable similarities across the entire group, despite wide variations in severity; was congruent with standard definitions of ASD; showed many features of childhood BPAD, including affective extremes, cyclicity, obsessive traits, special abilities, and regression after initial normal development; and differed from that of autistic children with neurological etiologies. These observations support the concept that ASD in some cases may be etiologically related to BPAD.

Adolescent↗
PubMed1998

[Differential language comprehension disorders: results of an explorative study].

OBJECTIVES: Deficits in the expressive language abilities of children are easily observed. Thus these children usually are detected early and receive appropriate professional help. Receptive language abilities are much more difficult to assess, so that deficits either go unnoticed or often are not treated early. METHODS: In a population of 100 children examined between 1993 and 1995 in the outpatient department for speech, language and behavior problems at the Heckscher Klinik in Munich-Solln and diagnosed as having clinically relevant deficits in language comprehension, we determined the ICD-10 diagnostic category into which the symptom "language comprehension deficit" would best fit. RESULTS: 16 children exhibited language comprehension deficits that were part of a general mental retardation, three other children were diagnosed as having a pervasive developmental disorder. 81 children fulfilled the clinical ICD-10 criteria of a specific receptive language disorder, often in combination with a hyperkinetic syndrome or an emotional disorder. For 42 of these children this diagnosis also was confirmed by test results showing a discrepancy of one standard deviation between the language comprehension test and the non-verbal IQ. The value of language tests for the diagnosis of specific developmental speech and language disorders is discussed.

Adolescent↗
PubMed1978

Lithium carbonate use in children and adolescents. A survey of the literature.

One hundred ninety cases of lithium carbonate use in children and adolescents are reviewed and divided by the authors according to DSM-II criteria into major affective disorders, behavior disorders of childhood and adolescence, and schizophrenia, childhood type. Of these 190 cases, only 46 cases were described in detail. In this group of 25 males and 21 females, aged 3 to 19, there were 30 positive responses to lithium carbonate. A family history of diagnosed manic-depressive illness was reported in only eight cases, while 19 had a family history of other psychiatric disorders. We were impressed by the affective component, irrespective of diagnosis, in youngsters responding to lithium carbonate and by the use of the drug despite multiple neurological problems. Thirty cases had positive neurological findings. Nevertheless, the many incompletely reported cases prevent conclusive generalization and demonstrate the need for well-documented studies correlating clinical, familial, and biochemical indices.

Adolescent↗
PubMed1993

The impact of young children with externalizing behaviors on their families.

Compared the impact on families of young children with externalizing behaviors (e.g., hyperactive, aggressive; n = 22), autism (n = 20), or no significant problem behaviors (n = 22) on several measures of family functioning. Previous studies have found heightened stress and parental maladjustment in families with externalizing children. The present study expanded upon that literature by (1) including a clinical control group to determine the specific impact of externalizing problems, (2) focusing on preschool aged children, and (3) using a new measure to directly ascertain parents' perception of impact. Compared to parents with normally developing children, parents with externalizing children reported more negative impact on social life, more negative and less positive feelings about parenting, and higher child-related stress. Moreover, parents of externalizing children reported levels of impact and stress as high as those reported by parents of children with autism. On broader measures of parental and marital well-being, however, the three groups of families of preschoolers did not differ. The implications of these findings for intervention are discussed.

Aggression↗
PubMed1984

Influence of pimozide on hypothalamo-pituitary function in children with behavioral disorders.

Hypothalamo-pituitary functions were examined in thirteen children with behavioral disorders (six with hyperkinesia, four with autism, two with tic and one with schizophrenia) before and during treatment with pimozide, an antidopaminergic drug. The mean (+/- S.E.M.) basal serum PRL level (24.5 +/- 4.2 ng/ml) during pimozide treatment was significantly higher than that (12.4 +/- 3.2 ng/ml) before treatment. Hyperresponse of PRL to TSH releasing hormone (TRH) was observed in five (three with hyperkinesia, one with tic and one with autism) of the thirteen patients before treatment and in seven (four with hyperkinesia, two with autism and one with tic) during treatment. Mean TSH response during treatment was not significantly different from that before treatment. However, three of the four autistic children showed hyperresponse of TSH to TRH before treatment, whereas only one also showed a hyperresponse during treatment. The pimozide treatment had no demonstrable influence on GH or cortisol secretion in response to insulin-induced hypoglycemia, or on serum T4 and T3 levels.

Adolescent↗
PubMed2005

Maternal depression and children's antisocial behavior: nature and nurture effects.

BACKGROUND: Children of depressed mothers have elevated conduct problems, presumably because maternal depression disrupts the caregiving environment. Alternatively, the association between maternal depression and children's antisocial behavior (ASB) may come about because (1) depressed women are likely to have comorbid antisocial personality traits, (2) depressed women are likely to mate and bear children with antisocial men, or (3) children of depressed mothers inherit a genetic liability for psychopathology. METHOD: We used data from the E-Risk Study, a representative British cohort of 1116 twin pairs assessed at 5 and 7 years of age. We tested for environmental mediation of the association between maternal depression during the children's first 5 years of life and children's ASB at age 7 years, free from familial liability for ASB. RESULTS: Maternal depression occurring after, but not before, the twins' birth was associated with child ASB and showed a significant dose-response relationship with child ASB at 7 years of age. Parental history of ASPD symptoms accounted for approximately one third of the observed association between maternal depression and children's ASB, but maternal depression continued to significantly predict children's ASB. Intraindividual change analyses indicated that children exposed to their mother's depression between ages 5 and 7 years showed a subsequent increase in ASB by age 7 years. The combination of depression and ASPD symptoms in mothers posed the greatest risk for children's ASB. CONCLUSIONS: Studies ignoring genetic transmission overestimate social transmission effects because both genetic and environmental processes are involved in creating risk for ASB in children of depressed mothers. Interventions for depressed mothers aiming to reduce conduct problems in their children should address parents' antisocial personality, as well as mothers' depression.

Adult↗
PubMed1976

Mania in childhood: case studies and literature review.

Criteria for mania in children have been established on the basis of criteria for mania in adults. Mania in children is an episodic disorder characterized by marked irritability and agitation, a considerable increase in activity level, push of speech, sleep disturbances, distractability, and noticeable mood instability that persists for longer than one month. Euphoria is frequently present in children with mania and is manifested as an adamant denial of any illness or problem. Previous reports have not stressed the characteristic appearance of depressive symptoms, such as hopelessness and helplessness, crying spells, death wishes, and beliefs of persecution, all of which can occur during the manic episode in children.

Affective Symptoms↗
PubMed1977

Neurobiologic antecedents of schizophrenia in children. Evidence for an inherited, congenital neurointegrative defect.

In chronic schizophrenics, disordered motor development in childhood is followed by more early cognitive and social impairment and poorer outcome; childhood schizophrenics represent the most extreme variants of this. Preschizophrenic infants show a fluctuating dysregulation of maturation--or "pandevelopmental retardation" (PDR)--that involves physical growth; gross motor, visual-motor, and cognitive development; proprioceptive and vestibular responses; muscle tone; and possibly arousal. Pandevelopmental retardation was significantly related to a genetic history for schizophrenia (less than .05), but not to obstetric complications. The severity of PDR was significantly related to the severity of later psychiatric and cognitive disorder (less than .01). Pandevelopmental retardation provides a "marker" in infancy for the inherited neurointegrative defect in schizophrenia. These disordered functions should be studied by anyone interested in the biology of the schizophrenic genotype or in specific early interventions for children at risk.

Adult↗
PubMed2004

Four-year prospective outcome and natural history of mania in children with a prepubertal and early adolescent bipolar disorder phenotype.

BACKGROUND: Diagnosis of child mania has been contentious. OBJECTIVE: To investigate natural history and prospective validation of the existence and long-episode duration of mania in children. DESIGN: Four-year prospective longitudinal study of 86 subjects with intake episode mania who were all assessed at 6, 12, 18, 24, 36, and 48 months. The phenotype was defined as DSM-IV bipolar I disorder (manic or mixed) with at least 1 cardinal symptom (elation and/or grandiosity) to ensure differentiation from attention-deficit/hyperactivity disorder. Parent and child informants were separately interviewed, by highly experienced research nurses, using the Washington University in St Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS). A Children's Global Assessment Scale score of 60 or less was needed to establish definite impairment. Treatment was by subjects' community practitioners. SETTING: Research unit in a university medical school. PARTICIPANTS: Subjects were obtained from psychiatric and pediatric sites by consecutive new case ascertainment, and their baseline age was 10.8 +/- 2.7 years. Onset of the baseline episode was 7.4 +/- 3.5 years. (Data are given as mean +/- SD.) MAIN OUTCOME MEASURES: Episode duration, weeks ill, recovery/relapse rates, and outcome predictors. RESULTS: Prospective episode duration of manic diagnoses, using onset of mania as baseline date, was 79.2 +/- 66.7 consecutive weeks. Any bipolar disorder diagnosis occurred during 67.1% +/- 28.5% of total weeks, during the 209.4 +/- 3.3 weeks of follow-up. Subjects spent 56.9% +/- 28.8% of total weeks with mania or hypomania (unipolar or mixed), and 38.7% +/- 28.8% of these were with mania. Major or minor depression and dysthymia (unipolar or mixed) occurred during 47.1% +/- 30.4% of total weeks. Polarity switches occurred 1.1 +/- 0.7 times per year. Low maternal warmth predicted faster relapse after recovery from mania (chi(2) = 13.6, P =.0002), and psychosis predicted more weeks ill with mania or hypomania (F(1,80) = 12.2, P =.0008). Pubertal status and sex were not predictive. (Data are given as mean +/- SD.) CONCLUSIONS: These findings validate the existence, long-episode duration, and chronicity of child mania. Differences from the natural history of adult bipolar disorder are discussed.

Adult↗