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

We reviewed pharmacological treatments used in children with autism and PDD-NOS who present with hyperactive symptoms. Some 41 studies were identified from the following drug categories: antipsychotics (n = 13), serotonin reuptake inhibitors (n = 3), antianxiety drugs (n = 4), psychostimulants (n = 10), alpha adrenergic agonists (n = 2), opiate blockers (n = 7), and other drugs (n = 2). Empirical evidence for significant reductions in hyperactive symptoms was strongest for the antipsychotics, psychostimulants, and naltrexone. Most studies have focused on the reduction of overactivity, and more emphasis needs to be placed on distractibility and attentional variables. A theoretical model was proposed in which participants' attentional performance may be used to predict clinical response to psychostimulants. More carefully controlled and comprehensive studies of hyperactivity are badly needed in these children.
J Autism Dev Disord 2000 Oct
PMID:Pharmacotherapy for hyperactivity in children with autism and other pervasive developmental disorders. 1109 83

Eighteen preschool children diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders Third Edition Revised (DSM III-R) as having Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) were compared to 176 children with DSM III-R Autistic Disorder (AD), and to 311 non-autistic children with developmental language disorders (DLD) (N = 201) or low IQ (N = 110). All children were partitioned into "high" and "low" cognitive subgroups at a nonverbal IQ of 80. Within cognitive subgroups, the 18 PDD-NOS children did not differ significantly from either the DLD or the AD children in verbal and adaptive skills and obtained scores intermediate between those of these groups. The PDD-NOS did not differ from the AD children in maladaptive behaviors. Both the PDD-NOS and AD children had many more of these behaviors than the non-autistic comparison groups. Children in the "high" and "low" cognitive subgroups of AD, but not of PDD-NOS, differed substantially on most measures, with the children with lower cognitive scores significantly more impaired on all measures. Similarity of PDD-NOS children to AD children in maladaptive behaviors and an intermediate position between autistic and non-autistic groups on virtually all measures explains the difficulty clinicians encounter in classifying children with PDD and raises questions about the specificity of these diagnostic subtypes of the autistic spectrum.
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PMID:Autistic disorder versus other pervasive developmental disorders in young children: same or different? 1131 38

Thirty-five children who received an autism spectrum diagnosis at the age of 2 years (24 with autism, 11 with PDD-NOS) were re-evaluated 2 years later to examine factors related to the development of spoken language. Child variables (play level, motor imitation ability and joint attention) and environmental variables (socioeconomic status and hours of speech/language therapy between ages 2 and 3) were used to predict an aggregate measure of language outcome at age 4. After controlling for age 2 language skills, the only significant predictors were motor imitation and number of hours of speech/language therapy. Implications of these results for understanding the early developmental course of autism spectrum disorders and the effects of intervention are discussed.
Autism 2001 Dec
PMID:Predicting spoken language level in children with autism spectrum disorders. 1177 53

This study examined predictors of developmental outcomes in 17 children diagnosed with autism or PDD-NOS, who received generic treatment over a mean period of 37 months. Pre-treatment evaluations occurred at a mean age of 31 months with follow-up evaluations at a mean age of 69 months. Significantly different developmental trajectories were observed among the participants at follow-up, separating the participants into two distinct groups (high and low outcome). However, groups did not differ significantly in treatment intensity or other outcome prediction measures. Pre-treatment developmental intelligence levels between the two groups approached significance. The results raise questions regarding the effect of treatment intensity and type, family stress factors, and intelligence ability in very early childhood on, outcome.
Autism 2001 Dec
PMID:Predictors of treatment outcome in young children with autism: a retrospective study. 1177 57

Some children with autism and pervasive developmental disorder-not otherwise specified (PDD-NOS) have been reported to have atypical feeding behavior, such as sensitivity to food texture and selective preferences for particular foods. No systematic studies of feeding behavior in this population have been published. Munk and Repp (1994) developed methods for assessing feeding problems in individuals with cognitive and physical disabilities that allow categorization of individual feeding patterns based on responses to repeated presentations of food. In this study, we systematically replicated the Munk and Repp procedures with children with autism and PDD-NOS. Thirty children, ages 3 to 14 years, were exposed to 12 food items across 6 sessions. Food acceptance, food expulsion, and disruptive behavior were recorded on a trial-by-trial basis. Approximately half of the participants exhibited patterns of food acceptance, indicating selectivity by food category or food texture. Others consistently accepted or rejected items across food categories. Whether these patterns of food acceptance are atypical remains to be determined by comparison with the feeding patterns of typically developing children and other children with developmental delays.
J Autism Dev Disord 2001 Oct
PMID:An assessment of food acceptance in children with autism or pervasive developmental disorder-not otherwise specified. 1179 15

The Pervasive Developmental Disorders (PDDs) constitute a group of behavioral and neurobiological impairment conditions whose main features are delayed communicative and cognitive development. Genetic factors are reportedly associated with PDDs and particular genetic abnormalities are frequently found in specific diagnostic subgroups such as the autism spectrum disorders. This study evaluated cytogenetic and molecular parameters in 30 youths with autism or other PDDs. The fragile X syndrome was the most common genetic abnormality detected, presented by 1 patient with autism and 1 patient with PPD not-otherwise specified (PPD-NOS). One girl with PDD-NOS was found to have tetrasomy for the 15q11-q13 region, and one patient with autism exhibited in 2/100 metaphases an inv(7)(p35q36), thus suggesting a mosaicism 46,XX/46,XX,inv(7)(p15q36) or representing a coincidental finding. The high frequency of chromosomopathies support the hypothesis that PDDs may develop as a consequence to chromosomal abnormalities and justify the cytogenetic and molecular assessment in all patients with PDDs for establishment of diagnosis.
J Autism Dev Disord 2002 Feb
PMID:Molecular and cytogenetic analyses on Brazilian youths with pervasive developmental disorders. 1191 31

This study explored the relation of severity of functional impairment on the Childhood Autism Rating Scale-Parent version (CARS-P) to diagnosis, parenting stress, and child age. Twenty-two mothers of children with autism and 19 mothers of children with pervasive developmental disorder-not otherwise specified (PDD-NOS) completed the CARS-P and the Parenting Stress Index. The autism group received significantly higher (i.e., more severe impairment) CARS-P ratings that did the PDD-NOS group. For the total sample, severity of impairment was a significant predictor of child-related parenting stress. The CARS-P was inconsistently associated with age-significantly positive for the PDD-NOS group but nonsignificantly for the autism group. Implications for the use of the CARS-P in assessment of children and the evaluation of interventions are discussed.
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PMID:Relation of the childhood autism rating scale-parent version to diagnosis, stress, and age. 1210 89

This study examined the association between adaptive behavior and general cognitive level in individuals with autism or PDD-NOS with and without comorbid mental retardation. Data from the screening version of the Vineland Adaptive Scales and the Wechsler Intelligence Scales were analysed in a sample of 67 subjects. While in the higher functioning individuals (IQ > 70, n = 34) IQ and adaptive behavior level differed significantly, performances were fairly comparable in subjects showing lower cognitive functioning (IQ < 70, n = 33). Regression models revealed a higher correlation between IQ and single adaptive behavior domains in the non-mentally retarded participants, with the domain Communication reaching the highest predictive power of the single adaptive behavior areas. Findings indicate, the relationship between adaptive and cognitive function in autistic disorders is mediated by the presence of a qualitative reduction of intelligence. Methodological limitations of the study are discussed.
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PMID:The relation between general cognitive level and adaptive behavior domains in individuals with autism with and without co-morbid mental retardation. 1246 53

There is consensus about the disorders that comprise the autistic spectrum, with autistic disorder, Asperger's disorder, and PDD-NOS as the most typical examples and Rett's disorder and disintegrative disorder as the other components. Important controversies regarding the precise definitions of autistic spectrum disorders and the boundaries between the milder manifestations of those disorders, particularly PDD-NOS, and non-autistic conditions have not been and cannot be resolved fully as long as there is no known biologic cause or consistent biologic or psychological marker. This includes issues as basic as whether the autistic spectrum is a predominantly unitary entity or a collection of more or less similar phenotypes with multiple, varying etiologies. This is why the highest long-term priority in the area of definite diagnosis is the search for biologic marker(s) for autism and related autism spectrum disorders [91]. In the absence of a medical test to unequivocally diagnose autism, definitions of autism and related conditions are based only on manifestations in overt behavior, with all the unreliability this entails. In the future, the discovery of biologic correlates, causes, and pathogenetic pathways will undoubtedly change the way in which autism is diagnosed and lead to a new nosology [95]. Until that time the definitions in the current versions of the classification systems should be considered in a state of evolution. The key problem of the current classification systems is the fact that the boundaries between the various disorders are fuzzy. Instead of a categorical approach, a more useful description might be that of "autistic spectrum disorder," which reflects the range of severity of symptoms. Such a dimensional understanding of PDD is useful to clinicians, who may otherwise use nonspecific terms to avoid the categorical diagnosis of autism [31]. Rutter and Schopler [96] argued for separate clinical and research schemes because clinical and research needs are different. For research purposes it is desirable to have as much direct comparability across studies as possible. The focus is on a high degree of homogeneity within diagnostic groupings. A price must be paid for this detailed specification, and the main cost lies in the proportion of cases left undiagnosed. For example, there may be good scientific reasons for a narrowly defined categorical diagnosis that includes only individuals who definitely and clearly have a specifically defined condition and excludes individuals who may have the condition. For clinicians and educators, classification helps guide the selection of treatments for an individual. From this point of view, broader diagnostic concepts may be most appropriate [95].
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PMID:The autistic spectrum: subgroups, boundaries, and treatment. 1246 62

The PDD Behavior Inventory (PDDBI) is a rating scale filled out by caregivers or teachers that was designed to assess children having a Pervasive Developmental Disorder (PDD; autism, Asperger disorder, PDD-NOS, or childhood disintegrative disorder). Both adaptive and maladaptive behaviors are assessed in the scale, making it useful for treatment studies in which decreases in maladaptive behaviors and improvements in adaptive social and language skills relevant to PDD are expected. The adaptive behaviors assessed include core features of the disorder such as joint attention skills, pretend play, and referential gesture. The maladaptive behaviors sample a wide variety of behaviors observed in both lower- and higher-functioning individuals and include stereotyped behaviors, fears, aggression, social interaction deficits, and aberrant language. The inventory was found to have a high degree of internal consistency. Inter-rater reliability was better for adaptive behaviors than for maladaptive behaviors. Factor analyses confirmed the structure of the PDDBI and indicated good construct validity. In a subsample of children between 3 and 6 years of age, raw scores for adaptive behaviors increased with age in the parent and teacher versions, as did measures of social pragmatic problems. It was concluded that the PDDBI is both reliable and valid and is useful in providing information not typically available in most instruments used to assess children with PDD.
J Autism Dev Disord 2003 Feb
PMID:The PDD Behavior Inventory: a rating scale for assessing response to intervention in children with pervasive developmental disorder. 1270 78


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