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[Diagnostic and etiopathogenic aspects of autism].

The Pervasive Developmental Disorders are a very complex and discussed subject both from a clinical point of view and about the etiopathogenesis. Different opinions have generated, in the past, different classification systems based on the underlying theoretical hypothesis. Nowadays the most popular classification systems are the ones contained in the DSM-IV and in the ICD-10. They define these diseases as "conditions characterized by a distortion of base development regarding verbal and non-verbal communication, the reciprocal and social ability of interaction and the imaginative activity." Inside this scenery are also compromised the motion activity, the awareness, the sensorial perception, the humour and the knowledge ability. About the pathogeny, nowadays many authors think autism is based on particular biological conditions, nevertheless they are not well-known or general. The exact origins of the rise of autistic disease are, in fact, still hypothetical. In the same way the concatenation of pathological events determining the arise of such a complex and wide clinical condition is also hypothetical. The discussion is mainly about the classification of childhood autism as a pure organic pathology or as a final expression of organic, psychic, familiar and social factors correlating with wrong operating structures, differentiated from an anatomic and functional point of view. So it seems quite plausible to take into account the possibility of a multisystemic compromise likely generated by a multifactor condition.

Autistic Disorder↗
PubMed1997

The identification of pervasive hyperactivity: is clinic observation necessary?

Three groups of hyperactive children (clinic observed, reported and situational) and a normal control group were compared on measures of behavioural, developmental and cognitive functioning. The clinic observed and reported groups did not differ significantly on any of the dependent variables. Situationally hyperactive children were less active, and had fewer behavioural and social difficulties than children with pervasive hyperactivity. Normal control subjects were distinguished by their better academic and social performance, and the absence of behaviour problems, language delay and hearing concerns. The data support the distinction between pervasive and situational hyperactivity, but not the separation of pervasive hyperactivity into clinic observable and reported hyperactivity.

Achievement↗
PubMed1994

Generalizing spontaneous language in developmentally delayed children via a visual cue procedure using caregivers as therapists.

Developmentally delayed children are recognized by deficits in language, motor skills, and social interaction. The importance of this topic is demonstrated by the fact that many studies have focused on increasing different aspects of this population's language. New training elements for this population were used here (e.g., the visual cue method was used in home settings). Caregivers were trained as therapists to teach children spontaneous speech by targeting two behaviors. The visual cue method was effective for increasing spontaneous speech in developmentally delayed children in the home. This finding is significant in that home training with caregivers promoted generalization of language by programming common stimuli. Implication of these data for future research is discussed.

Caregivers↗
PubMed1997

Children with a pervasive developmental disorder, children with a language disorder and normally developing children in situations with high- and low-level involvement of the caregiver.

The social behaviour of low-functioning children with a Pervasive Development Disorder (PDD), high-functioning children with a PDD, children with a Language Disorder (LD) and normally developing children (ND) was investigated in a playroom session while they were interacting with one of their parents. High-functioning children with a PDD were found to differ from the other groups in social responsivity. Low-functioning children with a PDD differed from high-functioning children with a PDD in the total number of social bids, type of social bids, number of looks at parent and social responsivity. When parents structured the behaviour of their children, this resulted in an increase in number of social bids and looks in the low-functioning children with PDD.

Attention↗
PubMed1987

Word recognition and comprehension skills in hyperlexic children.

Five hyperlexic boys (4-5 to 10-1 years), who had been diagnosed with infantile autism or pervasive developmental delay in early childhood, were evaluated. Measures of intelligence, single-word recognition and comprehension, and picture naming were administered to determine the precocity or deficiency of reading recognition and comprehension, the underlying mechanisms of oral reading, and possible parallels with the acquired dyslexia subtypes. The results indicated that hyperlexia may be operationalized as unexpected reading precocity as compared to IQ; however, reading comprehension was not unexpectedly deficient. The phonological route to reading appeared to be preferred to the lexical route, and the overall pattern of performance most closely paralleled that of the surface dyslexic subtype.

Autistic Disorder↗
PubMed1997

A comparison of speaking and mute individuals with autism and autistic-like conditions on the Autism Behavior Checklist.

The item, total, and subscale scores on the Autism Behavior Checklist (ABC) were compared for 155 mute and 335 speaking individuals with autism spectrum disorders. Although no significant difference was observed between the groups on the ABC total score, the mute group demonstrated significantly more pathology on 21 of 57 items and 3 of 5 subscales. The speaking group obtained significantly higher scores on only 8 items and 1 subscale (Language). The appropriateness of providing greater pathology scores on expressive language items to speaking, rather than to mute, individuals is called into question. The authors speculate whether the expressive language items are weighted too heavily, in regard both to the Language subscale and to the ABC total score. If the expressive language items were removed, the mute group would have significantly higher ABC total scores and therefore a greater degree of autism severity.

Adolescent↗
PubMed1994

Parent and teacher agreement in the assessment of pervasive developmental disorders.

Although it is well known that informants often disagree about the degree of psychopathology in children, this issue has not been systematically evaluated in children with autism. The objective of this paper is to estimate the extent of agreement between parents and teachers on the assessment of autistic symptoms and adaptive behavior skills. We assessed 83 children, 4-6 years of age, with a diagnosis of pervasive developmental disorder (PDD), using the Autism Behavior Checklist (ABC) and the Vineland Adaptive Behavior Scales (VABS). Parents and teachers rated each child on each measure. While there was good agreement between informants on the VABS, teachers tended to rate the PDD children higher than parents. In contrast, there was virtually no agreement on the ABC. High levels of stress experienced by parents appeared to be associated with parents reporting more autistic behaviors and less adaptive skills than teachers. As with other child psychiatric disorders, caution must be exercised in combining information from several informants.

Activities of Daily Living↗
PubMed1986

The Lowe and Costello Symbolic Play Test in socially impaired children.

The Symbolic Play Test was given to 31 socially impaired and 29 sociable children retarded in language comprehension, with the same range of age (5 to 12 years) and intelligence (profoundly retarded to normal). Play test age and spontaneous pretend play were at a similar level in the sociable children, but, in the socially impaired, spontaneous pretend play was lower than the play test age would predict. In some of the latter it was absent, and in the others it was narrow and repetitive in form. For subgroups of socially impaired and sociable children with similar play ages, there was no significant difference in language comprehension age. The discrepancy, in socially impaired children, between levels on tests and spontaneous use of skills was discussed.

Age Factors↗
PubMed1993

A prevalence study of autism in tuberous sclerosis.

An estimate of the prevalence of autism in tuberous sclerosis (TSC) was made by interviewing the parents of 21 children between ages 3 and 11 ascertained during a previous population study of the condition in the West of Scotland. Five of the children (24%) were rated autistic and a further four (19%), all of whom were girls, had socially impaired behavior categorized as pervasive developmental disorder, without fulfilling all the DSM-III-R criteria for autism. One further boy had disruptive attention-seeking behavior that had excluded him from his normal school. The estimated prevalence from this study of autism in TSC is 1 in 4 children in general, and 1 in 2 of those with mental retardation. Tuberous sclerosis could be a significant cause of autism and pervasive developmental disorders, particularly in girls.

Autistic Disorder↗
PubMed1999

Multiplex developmental disorders. The role of communication in the construction of a self.

This article discusses the integration of various aspects of the child's development, particularly the development of language and communication and the way in which these developments interact to enable the child to construct a coherent sense of self. Multiplex developmental disorder is presented as an example of a disorder that affects several of these crucial strands of development. Recent research and controversies regarding the diagnostic descriptions of multiplex and other pervasive developmental disorders are presented. This discussion is used to illustrate the ways in which such disorders affect not only the individual aspects of development, but the child's ability to form a cohesive sense of self. The implications of these difficulties in self-definition for treating children with disorders that affect a variety of aspects of development are also discussed.

Child↗