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Query: UMLS:C0004352 (autism)
 32,579 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligands which go to specific receptor sites is being introduced in paediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in paediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in paediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in paediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are paediatric psychological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in paediatrics.
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PMID:Cerebral imaging in paediatrics. 969 65

Formerly thought to be a neurodegenerative disease, Rett syndrome (RS) is a neurodevelopmental arrest of the brain that almost exclusively affects females and occurs in a variety of racial and ethnic groups worldwide. RS begins in late infancy and is characterized by autistic and dementia-like behavior, ataxia, and purposeless hand movements. Its cause and mode of transmission are unknown in over 90% of cases; however, there is strong and convincing evidence that genetic factors play a major role. The reported incidence varies, but in the US, as many as one quarter to one third of female children in mental wards/institutions may be affected. RS has been mistaken for numerous other conditions, including autism, cerebral palsy, and mental retardation, but the clinical picture is unique: No other condition has a period of rapid deterioration followed by apparent stabilization or even improvement in autistic features, eye contact, seizure activity, and hand stereotypies. The diagnosis is supported by deceleration of head growth, evidence of neurologic regression with associated neurologic signs, and purposeless hand stereotypies, with a clinical history of developmental regression. The differential diagnosis often involves ruling out syndromes with similar signs of neurodevelopmental arrest--for example, meningitis or encephalitis; chromosomal disorders such as Angelman's syndrome and Prader-Willi syndrome; metabolic disorders such as ornithine carbamoyltransferase deficiency; disorders of organic acids and amino acids; neurovisceral storage diseases; mitochondrial cytopathy; and Batten disease, or infantile neuronal ceroid lipofuscinosis. Management encompasses a comprehensive medical, therapeutic, educational, and psychosocial approach, best provided through a team in collaboration with the community agencies that serve families and children with special needs.
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PMID:Understanding, Recognizing, and Treating Rett Syndrome. 974 85

Individuals with severe disabilities have often been denied the full range of vocational opportunities. Because of discrimination and oppression, and false beliefs regarding their skills, capacities, capabilities, and interests, individuals with disabilities have often been relegated to nonwork activities or sheltered work opportunities. Passage of legislation, such as the Developmental Disabilities Assistance and Bill of Rights Act of 1984 and Title VI, Part C of the Rehabilitation Act Amendments of 1986, in combination with systems change grants funded through Title III of the Rehabilitation Act, provided the basis for the initiation of a series of federal- and state-funded demonstration projects designed to provide opportunities and supports for individuals with severe or significant disabilities to work at competitive sites in the community. This model of vocational services, called supported employment, while initially conceived as a vocational program for individuals with mental retardation, has been modified to successfully provide services to individuals with mental illness, acquired brain injury, autism, cerebral palsy, physical disabilities, and other disabilities. A key to the success of these programs is the complementary working relationship between the case manager and the job coach. While there may be some overlap in what each brings to the person with a disability, each professional plays distinctive and critical roles in the carrying out of supported employment.
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PMID:Case management and supported employment: a good fit. 976 21

A population based statistical analysis was performed of the incidence of developmental disabilities in Higashi-Osaka, a city in Osaka Prefecture with a population of about 500,000. The number of live births during 1988-1992 was 24,980, of whom those with cerebral palsy (CP), severe motor and intellectual disability syndrome (SMIDS), infantile autism, mental retardation (MR) and Down syndrome numbered 30, 21, 26, 268 and 25, respectively. And the respective incidence rates per 1,000 were 1.20, 0.84, 1.04, 10.7 and 1.0. For CP, the percentage of premature children was 63%, higher than in previous reports. Extremely low-birth-weight premature children (< 999 g birth weight) were especially notable at 20% of the CP total. For SMIDS, it is more important to understand the significance of medical care to support sufferers' social lives. High functional autistic children could not be evaluated at our center, though autism accounted for 8.6% of mental retardation. The medical functions of community institutions enable them to perform continuous, population based study of the incidence and situation of developmental disabilities.
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PMID:[A study on incidence of developmental disabilities in Higashi-Osaka City, Japan, 1988-1992]. 1002 32

We investigated prospectively the incidence of autistic disorder (AD) in the neonatal intensive care unit and the risk factors associated with autistic development. The study population included the 5,271 children at St. Mary's Hospital and the diagnosis of AD was performed using DSM-III-R criteria. A total of 36 prenatal, perinatal, and postnatal factors were evaluated in the patients with AD, 57 cerebral palsy (CP), and 214 controls. AD was identified in 18 of the 5,271 children and the incidence was 34 per 10,000 (0.34%). This value was more than twice the highest prevalence value previously reported in Japan. Children with AD had a significantly higher history of the meconium aspiration syndrome (p = .0010) than the controls. Autistic patients had different risk factors than CP.
J Autism Dev Disord 1999 Apr
PMID:Brief report: incidence of and risk factors for autistic disorder in neonatal intensive care unit survivors. 1038 37

A delay in speech development may be a symptom of many disorders, including mental retardation, hearing loss, an expressive language disorder, psychosocial deprivation, autism, elective mutism, receptive aphasia and cerebral palsy. Speech delay may be secondary to maturation delay or bilingualism. Being familiar with the factors to look for when taking the history and performing the physical examination allows physicians to make a prompt diagnosis. Timely detection and early intervention may mitigate the emotional, social and cognitive deficits of this disability and improve the outcome.
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PMID:Evaluation and management of the child with speech delay. 1039 94

Concurrent with the sweeping changes in health care during the past decade, particularly in Medicaid financed health care, has been the reshaping of social policy toward people with developmental disabilities. The extent to which managed care entities match the themes now driving social services for people with mental retardation and other developmental disabilities (cerebral palsy, autism, etc.) is the extent to which they will be successful in serving this unique group of consumers of managed health care. The authors suggest a number of considerations for managed care organizations that increasingly serve significant numbers of this population.
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PMID:Serving people with developmental disabilities in Medicaid managed care. 1053 36

There are numerous pesticides and toxic chemicals in the environment that have yet to be evaluated for potential to cause developmental neurotoxicity. Recent legislation and testing initiatives provide an impetus to generating more information about potential hazards to children. In the United States, the 1996 Food Quality Protection Act (FQPA) required the U.S. Environmental Protection Agency (U.S. EPA) to make a finding that a pesticide food use is safe for children. In addition, the law requires U.S. EPA to incorporate an additional 10-fold factor in risk assessments for pesticide residue tolerances to take into account the special sensitivities of infants and children as well as incomplete data with respect to toxicity and exposures. The potential of chemicals in food and drinking water to cause endocrine disruption will also be examined via the Endocrine Disruptor Screening and Testing Program required by the FQPA and the 1996 Safe Drinking Water Act. In addition, a new voluntary chemical information program will provide screening-level information for the some 2,800 high-volume chemicals in commerce in the United States. These initiatives will need to be accompanied by research focused on developmental toxicity for children, including developmental disabilities. Developmental disabilities exact a large toll on children's health in the United States. Three major developmental disabilities--autism, cerebral palsy, and severe mental retardation--each affect substantial numbers of children. We know very little about the etiology of these conditions. A number of priority areas for research are suggested, including a large environmental prospective study of developmental neurotoxicity.
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PMID:Chemicals in the environment and developmental toxicity to children: a public health and policy perspective. 1167 32

The incidence of autism is increasing in both the USA and in Britain. There is still controversy over what causes autism and even greater controversy over selecting a preferred method of intervention and support (as there is no treatment for autism). Although there is now a general consensus that individuals may have a genetic predisposition to develop autism, it is also acknowledged that this may be off set by a range of environmental and/or biological factors. The understanding of the causation of autism is now considered in much the same way as we understand cerebral palsy, in that there can be a range of different reasons for causation and prevalence. This article, the first of two parts, will explore how an awareness and understanding of autism can enable nurses working with children with autism to provide more child-centred nursing care based on fact as opposed to stereotype and mythology surrounding autism. The second part will concentrate on adults with autism.
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PMID:Understanding children with autism: exploding the myths. 1123 99

All currently accepted definitions of autism include three main criteria which have to be met for a diagnosis to be made. These are: disturbance of reciprocal social interaction, disturbance of communication and restriction of normal variation in behaviour and interests. The criteria used in the ICD-10 include all these domains. On the other hand, the number of mentally handicapping conditions and brain damage syndromes show the same triad of symptoms. Many of patients actually fulfill all currently accepted criteria for autism, but, for some reason do not receive the diagnosis. We analysed retrospectively the clinical picture of all children hospitalised in Department of Child Psychiatry in the last 10 years before the introduction of ICD-10 in Poland (1986-1996) and diagnosed as having autism, autistic traits or features. The group consist of 19 children (0.8% of all children hospitalised in that time). 4 of them had been diagnosed as having autism, 4 as having features of autism and 11 as having autistic traits. Additional diagnoses were: organic brain damage in 2 children, carnitine deficiency and cerebral palsy in 1 child and minimal brain dysfunction in 3 cases. Despite of the diagnosis all children met current ICD-10 criteria for autism or atypical autism, according to age of onset. There were no significant differences in constellation of symptoms included in ICD-10 between groups divided according to the past diagnosis.
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PMID:[Features of autism, autistic traits, autism: retrospective analysis of clinical symptoms in children treated in the Pediatric Psychiatric Clinic]. 1132 83


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