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

This study is a companion to our 4-year study (Birenbaum, Guyot, & Cohen, 1990) on financing health care for individuals with autism or severe mental retardation. We reported on nonmedical expenditures and opportunity costs pertaining to maintaining a child or young adult with serious developmental disabilities in the home or in residential care and discussed policy implications for assisting their families. We proposed that (a) personal care and family support should be included in health care requirements, (b) family-centered care should be promoted, (c) appropriate programs and care should be provided for young adults no longer in school, (d) financing and organizing of family supports and subsidies should be administratively simple, (e) Medicaid should be expanded to increase use of home- and community-based services, and (f) financial support should be provided to families.
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PMID:On the importance of helping families: policy implications from a national study. 847 34

Autism and pervasive developmental disorder, not otherwise specified represent a complex developmental disability in which clinical signs include language delay, social unrelatedness, and unusual or restricted interests. Gradually a better understanding of these disorders as being neurologically-based developmental disorders with multiple etiologies has replaced the idea of emotional disturbance. Although pervasive developmental disorders are rare, the potentially devastating effects make early recognition by pediatricians imperative. Yet, despite promising treatment advances in education, communication technology, behavior treatments, and pharmacology, the prognosis for these disorders remains guarded.
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PMID:Autism and pervasive developmental disorders. 849 66

A parental survey that addressed the social sexual awareness, sex education, and sex behaviors of persons with autism, a developmental disability is provided. Questionnaires from 100 caregivers of persons with autism 9 years of age and older and with the DSM-III-R diagnosis were analyzed. Eighty-five percent of respondents were mothers, 8% both parents, 5% fathers, and 2% others; 32% of the persons with autism were female and 68% male with an age range of 9.1 to 38.9 years. The verbal level of the person with autism related to parents' beliefs about the relevance of sex relations (chi 2 = 6.99, p < 0.05) and sex education (chi 2 = 22.91, p < 0.001). No relationship between parents' report of the verbal level of the individual and the display of inappropriate sexual behaviors was found (chi 2 = 2.56, ns). Parents of males were more concerned about their son being taken advantage of by a same-sex person (chi 2 = 15.90, p < 0.001); parents of females were worried about an opposite-sex person (chi 2 = 4.06, p < 0.05). Parental concerns and beliefs regarding sexuality varied and could not be generalized. The nonsignificant finding regarding verbal level and display of inappropriate sexual behaviors suggests that the need for sex education is best determined by the behaviors of the person rather than the functioning or verbal levels.
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PMID:Social/sexual awareness of persons with autism: a parental perspective. 2688 98

Few data are available on the risk of seizures in young children with developmental problems. A retrospective evaluation of 1,946 children 0-5 years of age referred to the Tel Aviv Child Development Center (CDC) between 1981 and 1990 was performed. The study was undertaken to determine the cumulative risk of unprovoked seizures in children referred to a CDC and to assess the risk factors associated with seizures in these children. The center serves the Tel Aviv area for a variety of developmental disabilities. Cumulative risk of seizures and risk factors were assessed using Kaplan-Meier methodology. Unprovoked seizures occurred in 58 patients (3%), including 10 with a single seizure and 48 with two or more seizures. Risk factors for seizures included cerebral palsy (CP) (relative risk [RR] = 28.7), neonatal seizures (RR = 15.2), mental retardation (MR) (RR = 7.8), febrile seizures (RR = 7.7), autism (RR = 3.2), and prematurity (RR = 2.7). The cumulative risk of seizures by age 5 years in children with MR, CP, and MR plus CP was 8%, 47%, and 68%, respectively, compared with 1% in those without MR or CP. On multivariate analysis, CP, MR, prior febrile seizures, and prematurity were associated with an increased risk of seizures. The risk of experiencing unprovoked seizures by age 5 in children with developmental disabilities is 3%, which is fourfold greater than that of the general population. Much of this increased risk is limited to selected subgroups with major disabilities. However, if neither MR nor CP is present, the 1% risk of developing unprovoked seizures by age 5 in children with other developmental problems is not substantially different from that expected in the general population.
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PMID:Unprovoked seizures and developmental disabilities: clinical characteristics of children referred to a child development center. 855 61

This paper reports on the effect of using an interactive and child-initiated microcomputer program (Alpha) when teaching three groups of children (N = 30) reading and communications skills: (a) 11 children with autism (M chronological age, CA = 9:4 years), (b) 9 children with mixed handicaps (M CA = 13:1), and (c) 10 normal preschool children (M CA = 6:4 years). Their mental age varied from 5:8 years to 6:9 years and all children received computer instruction supplementary to their regular reading and writing activities. Tests of reading and phonological development were carried out at the onset of the training (Start), at the end (Post 1), and at a follow-up evaluation (Post 2). In addition, video observations of the childrens' verbal and nonverbal communication were added at Start and Post 1. The children with autism increased both their word reading and their phonological awareness through the use of the Alpha program. Clearly significant gains were observed during the intervention, but none during the follow-up period. A similar but weaker pattern is observed for the children with mixed handicaps. In contrast, the normal preschool children increased their scores regardless of the program. Analyses of the children's classroom behavior indicate that the intervention succeeded in stimulating verbal expressions among the children with autism and mixed handicap. A significant increase in enjoyment was also noted for the children with autism. It is concluded that the intervention with a motivating multimedia program might stimulate reading and communication in children with various developmental disabilities, but that such interventions must be individually based and include both detailed planning and monitoring from teachers, and parents, as well as from clinicians in charge.
J Autism Dev Disord 1995 Oct
PMID:Increasing reading and communication skills in children with autism through an interactive multimedia computer program. 856 93

Our understanding of neuropsychiatric abnormalities in patients with deletions of the long arm of chromosome 18 (18q- syndrome) is based mainly on sporadic case reports. We characterized the neuropsychiatric phenotype in 27 patients across a wide age range (2-47 years) with breakpoints ranging from 18q22.3-18q21.2. Adaptive behavior scores (Vineland Composite) were significantly higher in females than in males (62 +/- 5 vs. 43 +/- 3). Intelligence ranged from borderline to severely deficient (IQ, 73- < 40), with academic achievement similarly impaired. Performance in specific neuropsychological functions, including attention, novel problem solving, memory, language, visuomotor integration, and fine motor dexterity, was consistently in the moderately-to-severely impaired range. Behavioral problems were common in both sexes, including aggressivity, hyperactivity, and temper tantrums. Contrary to the few previous reports, we found no evidence of psychosis in any patients. In a subset of patients selected on the basis of no prior knowledge of behavioral problems, 1 of 16 patients (6%) had autism, as defined by the Autistic Diagnostic Interview--Revised (ADI-R) [Lord et al., 1994: J Autism Dev Disord 24:659-685]. Thus, the prevalence of autism in 18q- syndrome is probably no greater than that in other developmental disabilities with a similar level of cognitive impairment. In contrast to what has been believed since 18q- was first described 30 years ago, we found no relationship between chromosome deletion size and any measure of cognition or behavior; nor were there any correlations between any of these measures with the presence or absence of abnormalities on MRI or somatosensory-evoked potentials.
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PMID:Neuropsychiatry of 18q- syndrome. 872 44

The case of a 13-year-old boy with autism, severe mental retardation, and a seizure disorder who was able to demonstrate valid facilitated communication was described. In three independent trials, short stories were presented to him, followed by validation test procedures with an uninformed facilitator providing physical support to the subject's arm. In Trials 1 and 3, several specific answers were provided that clearly indicated that the young man, not the uninformed facilitator, was the source of the information. Moreover, some responses seemed to imply that the subject was employing simple inferential and abstract reasoning. This case study adds to the small, but growing number of demonstrations that facilitated communication can sometimes be a valid method for at least some individuals with developmental disabilities.
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PMID:A validated case study of facilitated communication. 882 41

Planned Activities Training (PAT) teaches mothers to plan and structure activities to prevent challenging child behaviors. PAT was evaluated with four mothers of children with developmental disabilities, including autism, Down Syndrome, and ADHD. PAT was used independent of any other behavior management techniques to examine its impact on mother and child behaviors, which were examined in addition to "fidelity" data on the mothers' implementation of PAT techniques. A multiple probe experimental design across two families with a replication across two more families demonstrated that PAT produced marked improvements in mother and child behavior in three generalization settings. In most cases, mothers' use of PAT procedures more than doubled. Three mothers' appropriate behavior increased from 25% to 40%. Improvements in child behavior ranged from 20% to more than 50%. Intervention gains were maintained at 1, 3, and 6 months. These results suggest that PAT is a useful technique for promoting durable generalization of mother child skills.
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PMID:Planned Activities Training for mothers of children with developmental disabilities. Community generalization and follow-up. 887 13

A group of Vancouver health professionals, including the authors, have studied the use of oral melatonin in the treatment of chronic sleep disorders in children with disabilities since the Fall of 1991. This review article is based on the first 100 patients, half of whom were visually impaired or blind. Children with neurological, neuropsychiatric, and developmental disabilities are predisposed to chronic sleep-wake cycle disturbances. Disorders such as blindness, deaf-blindness, mental retardation, autism, and central nervous system diseases, among others, diminish the ability of these individuals to perceive and interpret the multitude of cues for synchronizing their sleep with the environment. Melatonin, which benefitted slightly over 80% of our patients, appears to be a safe, inexpensive, and a very effective treatment of sleep-wake cycle disorders. The oral dose of fast release melatonin taken at bed-time ranged from 2.5 mg to 10 mg. Side effects or the development of tolerance have not been observed. Since the causes of sleep difficulties are extremely variable, not all children are candidates for treatment. For successful melatonin treatment, clinical experience is required, and the influences of other health problems and medications need to be considered. Further clinical and laboratory research in this field is imperative because melatonin treatment offers enormous health, emotional, social, and economic benefits to society, especially since multidisabled children with chronic sleep difficulties do not respond well to current therapeutic regimes.
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PMID:Use of melatonin in the treatment of paediatric sleep disorders. 898 17

In the context of an epidemiological study of autism in Nova Scotia, subjects were evaluated for minor physical anomalies and physical measurements. Normal control children, children with autism and their siblings, and children with developmental disabilities and their siblings were compared. Posterior rotation of the external ears was found to be a characteristic related to autism specifically, rather than to developmental disabilities in general. Small feet and normal-to-large hands also were observed in the autism group. Children with autism had a significant reduction in interpupillary distance, but not intercanthic distance or head circumference. In contrast, children with other developmental disabilities were notable for general small stature, which affected the hands, feet, eyes, and head size, as well as height. Abnormal ear configuration was the minor malformation most characteristic of the developmental disability group, and the subset of Down syndrome children had single transverse creases of the palm and epicanthic folds that resulted in significantly increased rates of these anomalies in the developmentally disabled controls. Siblings of the two disabled groups were not significantly different from normal controls on any of the measures that characterized children with autism or other developmental disabilities. The results agree with those of several previous studies, which have suggested that abnormalities of the ears are the general category of minor anomalies most associated with autism. Recent evidence regarding the embryological origin of autism suggests that the ear effects may be an important marker of the initiating events that lead to the disorder.
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PMID:Minor malformations and physical measurements in autism: data from Nova Scotia. 926 26


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