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

In a longitudinal evaluation study the developmental progress of 223 children, who have been treated between 1968 and 1987 in a residential facility for psychiatric care, was explored from referral until time of discharge. Initial state and state at discharge were defined multidimensionally according to MAS. Comparisons between children with different initial clinical diagnosis met expectations, that introversive disturbances recover more frequently than autistic as well as conduct disorders or hyperactivity. Associations between recovery and initial cognitive-intellectual state did not reach statistical significance, when type of disorder was controlled for. But rate of recovery appeared to be throughout higher for children with learning disabilities than for children without such deficits. Age at onset and age at referral were apparently rather irrelevant for the state at discharge. But rate of recovery was in general clearly reduced, when length of time between onset and referral had been above average. The relation between duration of treatment and state at discharge depended on the type of disorder. For children with conduct or autistic disorders the rate of recovery increased with longer duration of treatment, whereas for children with introversive disturbances the contrast was true. This could suggest confounding effects of severity of disorder. When the treatment in the facility had been precociously terminated, rate of recovery in general was remarkably lower than in case of a planned termination. Analysis on effects of alternative methods of treatment was only with restrictions possible and did not suggest a general or differential superiority of a special type of treatment.
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PMID:[Differential results of treatment in pedagogic-therapeutic long-term intervention in residential treatment centers for children]. 209 73

The Pervasive Developmental Disorders complications can lead to an important life long handicap. There is an important literature about autism, but in most cases, specifically concerning children and adolescents problems. We wished to focus our attention on adults, in order to describe, on one hand their socio-adaptive profile, and on the other hand, the necessity to resort to a psycho-active treatment. The geographic zone chosen in order to carry out this, was Languedoc-Roussillon, and the applied method was a descriptive study of psychotropic use in the 20-35 age adults with autism. The instruments used were standardized and validated. The diagnosis was confirmed using ICD 10 criteria checklist and individual characteristics including adaptive profile estimated on the Vineland scale, were collected. Moreover the prescriber's global impressions were collected on the CGI scale. Out of 165 case files collected, the sex-ratio was 3 men for 2 women, 45% showed associated somatic disorders (of which 24% epileptic), 66% -benefited from a psycho-active treatment; 85% had been admitted in institutions during childhood or adolescence. The admittance framework being respectfully, MAS 21.8%, community homes 35.2%, CAT 17.6% and psychiatric services 20.6%. Mean equivalent age, in the three Vineland adaptive domains, were from 21 months in Communication to 43 months in Autonomy in daily life Skills and 17 months in Socialization. The development quotient showed adaptive retardation in 100% of cases. The 110 persons benefiting from a medicinal treatment, were treated for aggressiveness in 62.7% of cases, agitation in 43.6% of cases and anxiety in 48.2% of cases. The therapeutic categories used were, in majority, antipsychotics in 85% of cases, anxiolitics in 40.2% of cases; hypnotics as well as anti-depressants or mood-regulators, each representing 10% of prescriptions. Associations of several molecules representing 83% of cases. The therapeutic effect was considered interesting in more than two-thirds of cases. Undesirable side-effects were reported in 50% of the patients under treatment; 50% of the persons treated had been administered the same treatment for more than 5 years. The adaptive-profile significantly varied, depending on the accommodation structures and also the presence or absence of a psycho-active treatment. The results of this study portrayed the level of social adaptation and the types of psychoactive treatment in adults with autism, who are severely limited in their adaptive functioning due to their handicaps.
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PMID:[Descriptive study of psychotropic use in the 20-35 age adults with autism in Languedoc-Roussillon]. 1614 44

We conducted functional analyses of pica for three individuals with varying levels of intellectual disabilities. In addition, two indirect assessment instruments (the Motivational Assessment Scale [MAS], and the Questions About Behavioral Function [QABF]) were also administered to both the parent and teacher of the child participants. Results of the functional analyses indicated that pica was sensitive to automatic reinforcement. Further, results of both the MAS and QABF also suggested behavioral sensitivity to automatic reinforcement.
J Autism Dev Disord 2009 Nov
PMID:Brief report: a comparison of indirect versus experimental strategies for the assessment of pica. 1948 46

In 2012, the US National Institute of Mental Health launched three clinical trial contracts under a new FAST initiative. The overall goal for these contracts (Fast-Fail Trials) was to focus early-stage trials, testing novel pharmacologic agents that target the central nervous system, on pharmacologic-based designs to objectively identify doses that produce central nervous system effects. The three contracts targeted different psychiatric populations: psychotic (FAST-PS), mood and anxiety (FAST-MAS), and autism spectrum disorders (FAST-AS). The FAST initiative was a first attempt for the National Institute of Mental Health to adapt an experimental medicine approach to its clinical trial portfolio. As the Fast-Fail trials implemented this new approach for the field, we present the rationale for each trial, design considerations, results, and how each one contributed new knowledge to the field of psychopharmacology; important lessons for pharma and biotech. Under the FAST initiative, the National Institute of Mental Health assembled research teams with a broad range of expertise, who developed and validated the outcome measures and study protocol, and conducted multi-site clinical trials, testing candidate compounds. In the FAST-PS contract, the team validated an imaging-based pharmacodynamic biomarker of the effect of ketamine in the brain that could be utilized in subsequent clinical trials. The initial FAST-AS study was an important first step in the design of early-stage target-engagement trials in autism spectrum disorder, suggesting that a resting electroencephalogram can be used as a pharmacodynamic measure in future studies. The FAST-MAS study showed that blocking the kappa-opioid receptor significantly affects functional magnetic resonance imaging ventral striatal activation in the monetary incentive delay task in anticipation of gain. Together, the outcomes of the FAST-FAIL trials demonstrated the importance of rigorously designed and informative central nervous system trials, including the value of pharmacodynamic measures in early-stage trials. Use of these measures furthered our knowledge about the relationship between specific molecular mechanisms, brain effects, and therapeutic effects in patients with mental illnesses.
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PMID:The NIMH 'Fast-Fail Trials' (FAST) Initiative: Rationale, Promise, and Progress. 3270 69