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Query: UMLS:C0004352 (autism)
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The concept of developmental disabilities as a group of problems with origins in the stages of human development has been broadened by recent legislation to include mental retardation, cerebral palsy, epilepsy, autism, dyslexia, and other neurological impairments. The debate continues on whether or not specific disability categories should be named, but the functional aspects of the problems seem to be generally accepted. Potential implications of this legislation for occupational therapy are discussed in this paper. Numerous programs supported by a variety of governmental units and private agencies will need qualified professionals. This paper concludes with a brief list of six developmental disability programs of the University of Michigan University Affiliated Facility and an outline of three models of field placement in developmental disabilities for occupational therapy students.
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PMID:Developmental disabilities. 7 85

Three biotelemetric examinations and a whole night sleep recording were carried out in an 8-year-old child whose behaviour alternated between excitation and autism with stereotypes. The EEG showed 5 c/sec temporo-parietal sharp wave discharges lasting from 1 sec to 20 min. These discharges were at times unilateral and predominantly right sided, at other times bilateral, without any clinical sign of epilepsy. The chronological distribution of right, left and bilateral discharges during the successive 1 min epochs was computed and related to corresponding 'behavioural states' of the child. The paroxysmal discharges predominated when the child was awake but not involved in any relational activity; during sleep, they mostly appeared during light NREM sleep (stage I) and paradoxical sleep. The significance of these paroxysmal discharges is discussed in relation to stereotyped behaviour, vigilance and early disorganization of biological rhythms.
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PMID:Long duration EEG studies in the case of a psychotic child. 8 47

Epilepsy represents a serious medical and social problem. In the majority of cases, seizures are successfully managed by a variety of anticonvulsant medications, even though these drugs may potentiate significant physical and developmental side effects. A small group of studies to date have offered evidence that behavioral procedures can successfully manage some seizure disorders and are particularly desirable treatment choices when seizure disorders are intractable to drug management or when drug side effects are to be avoided. The present case adds to this small but growing group of studies in that it demonstrates the use of behavioral procedures in the analysis and treatment of high-rate myoclonic seizures. Seizures were evaluated on a hospital ward and in a controlled experimental setting. The data indicated a variable rate of seizures across days and activities and a reduction of seizure frequency in the controlled setting when time-out was made contingent on seizures. A program of contingent rest' was then applied on the hospital ward that demonstrated a reduction in myoclonic seizure frequency and the apparent prevention of several grand mal episodes. An observer calibration procedure showed high correspondence between behaviorally and physiologically recorded seizures. A discussion of issues in behavioral medicine research follows.
J Autism Dev Disord 1979 Dec
PMID:A behavior analysis approach to high-rate myoclonic seizures. 11 52

Although the FDA recommends imipramine hydrochloride (IMI) only for temporary relief of symptoms of enuresis nocturna (EN), the drug has been applied to a number of other pediatric situations, including the Hyperkinetic Syndrome (HS), childhood depression, somnambulism and pavor nocturnus, school phobia, petit mal epilepsy, allergies, autism, encorpresis and head-banging. We have reviewed the literature, with particular attention to the pharmacokinetics of IMI in children, and its putative mechanisms of action. The drug probably works through a number of different actions, and the futher delineation of these will be of considerable heuristic value. We review the toxic effects of IMI treatment and IMI poisoning in children, and the pediatric literature concerning other antidepressant drugs and lithium carbonate (Li).
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PMID:Imipramine and children: a review and some speculations about the mechanism of drug action. 40 23

Folk concepts for mental disorder were studied among rural Lao people. While predominatly inferring etiology (e.g. spirit-caused disorder), certain terms also emphasized particular descriptive psychopathology or behavioral abnormality. Preventive strategies were stressed for insanity due to "excessive worry' or "broken taboo'. These broad folk categories of disorder bore considerable similarity to some psychiatric and neurologic categories within medicine. These includes psychosis, mania, neurosis, organic brain syndrome, mental retardation, cerebral palsy, epilepsy, and childhood autism. Lao folk terms for mental disorder also closely resembled those of other southern Asian cultures, although illiterate tribal peoples appeared to have fewer terms than literate peasant peoples. Folk terms from more distant regions had broad similarity to those of southeast Asia, but lacked the specificity found within the region.
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PMID:Folk concepts of mental disorder among the Lao: continuities with similar concepts in other cultures and in psychiatry. 52 21

It is suggested that damage by mild trauma, viruses or bone disease to the otic capsule or to the membranes between the cochlea and the middle ear is common, and involved in many syndromes of obscure etiology. The clinical perilymph fistula (PF) syndrome can consist of any combination of the following: tinnitus, deafness, phonophobia, vertigo, ataxia, otalgia, facial palsy, headache, diplopia, blackouts, psychological distress. The following testable hypotheses are proposed: otitis media is due to perilymph in the middle ear, with secondary changes resulting from infection or inflammation: otosclerosis results from a slow leak in the presence of enzymes promoting bone growth: Meniere's syndrome follows reduced perilymph support for the endolymphatic system: Bell's palsy results from a perilymph provoked oedema in the bony facial nerve canal: PFs may be responsible for progressive rubella deafness, and for some cases of migraine, epilepsy, anxiety neurosis and hysteria: psychiatric sequelae of the PF syndrome predominate in the post-concussional syndrome and infantile autism: organisms can pass from the throat into the spinal fluid, causing meningitis or encephalitis. The tinnitus and vertigo are caused by random labyrinthine fluid movements, the headache and diplopia by reduced spinal fluid pressure.
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PMID:Perilymph fistula: a cause of auditory, vestibular, neurological and psychiatric disorder. 78 62

In a department of infantile psychiatry half of children have at least 1 alcoholic parent (66 over 136). We have compared 2 groups of children: one group of 66 children of alcoholics (65 alcoholic fathers 28 alcoholic mothers), and one group of children without alcoholic parent. In both group psychiatric illness is common: for children of alcoholics mental troubles needing psychiatric cares are found for 44 mothers and 20 fathers. Among children of non-alcoholic parents mental troubles are found for 19 mothers and 10 fathers. Alcoholic parents are more often divorced (21%) and only 40% are living together. Only 46.9% of children of alcoholics are bred by non-parental persons (28.5% for children of non-alcoholics). Some data (with statistical analysis) are given on children development and psychiatric symptoms. Half of 2 groups of children show mental deficiency. Among children of alcoholics character disorders and idiopathic epilepsy are more frequent. Among children of non-alcoholics cerebral damage and symptomatic epilepsy and possibly infantile psychosis are more frequent. This emphasizes evidence for many pathogenic factors and very bad milieu conditions. These offsprings of alcoholics are children at very high risk.
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PMID:[Children of alcoholics. Survey of 66 children of alcoholics in a child psychiatry service]. 121 13

Alpha rhythm is classically described as a bilateral posterior rhythm of substantially constant frequency in the range of 8-13 Hz which is enhanced by mental relaxation and blocked by attention. Since the full expression of alpha rhythm has been shown to occur coincident with puberty, it is possible that the establishment of alpha rhythm is subject to neuroendocrine influences which govern psychosexual maturation. There is ample evidence to indicate that the pineal gland is implicated in cerebral maturation and psychosexual development. Nocturnal plasma melatonin levels have been shown to decline progressively throughout childhood reaching a nadir at puberty. Since administration of melatonin has been reported to block alpha rhythm, it is proposed that the progressive decline in melatonin secretion during childhood facilitates the maturation of the alpha rhythm. Consequently, the presence of alpha rhythm could be used as a neurophysiological marker for the activity of the pineal gland and disorders associated with absent or delayed maturation of the alpha rhythm such as autism, dyslexia, personality disorders, epilepsy, Tourette's syndrome, and schizophrenia might be related to disturbances of pineal melatonin functions in early life. Moreover, since the EEG patterns associated with cerebral immaturity (i.e., slowing, absence of alpha activity) are more pronounced in the left hemisphere, this hypothesis implies differential influence of the pineal gland on hemispheric maturation potentially accounting for the vulnerability of the left hemisphere to cerebral insults.
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PMID:Alpha rhythm and the pineal gland. 130 57

A survey conducted in four French regions identified a sample of 154 autistic children born in the birth cohorts 1972 and 1976. Their mean ages were respectively 6.9 and 5.5 years when their handicaps were registered to local administrative services. The overall prevalence estimate is 4.9/10,000, with little difference between the two cohorts. The boy/girl sex ratio is 2.1:1, and more than two thirds are mentally retarded. The SES distribution does not deviate from census data. An elevated incidence of epilepsy is found (22%), with higher rates among the most retarded subjects and those with perinatal antecedents. Otherwise, relatively few autistic subjects were reported to have a clearcut medical disorder known for its association with autism.
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PMID:Prevalence of infantile autism in four French regions. 141 50

We report the case of a boy whose development was normal until the age of three when regression with loss of speech occurred. Other anomalies included eating and sleep disorders, sterotyped behavior disorders, suggesting infantile psychosis. The electroencephalogram evidenced paroxysmal anomalies, particularly during sleep, with no clinical seizures. The diagnosis of epilepsia-acquired aphasia syndrome (Landau-Kleffner syndrome) was made. The psychotic disorders were not considered as a differential diagnosis but rather as intertwined with the elements of the syndrome. The relationship between acquired aphasia and psychosis are discussed.
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PMID:[Epilepsy-acquired aphasia syndrome with psychosis. Report of a case ]. 169 43


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