PubMed Health⌕ Search

Biomedical subjects

A M Small

Publications and source records attributed to A M Small.

At least 19 recordsLinked to original sources
PubMed1995

A comparison of live and videotape ratings: clomipramine and haloperidol in autism.

This study compared live ratings with ratings of videotapes and compared response to clomipramine with response to haloperidol in 8 subjects, mean age 5.62 years, who met criteria for autism. They were consecutive admissions to a pilot study of clomipramine (n = 4) or a double-blind, placebo controlled study of haloperidol (n = 4). Live ratings were performed by two raters at the end of the pre-treatment placebo baseline period and at the end of the drug treatment period on the CPRS and the CGI and were videotaped. Employing the same instruments, these videotapes were rated by two raters who did not know the subjects and were blind to study design, treatment, and study phase. Ratings of videotapes significantly differed from live ratings. A treatment effect for haloperidol was detected only on live ratings and not on ratings of videotapes. No treatment effect was detected for clomipramine in either live or videotape ratings.

Autistic Disorder↗
PubMed1992

Side effects associated with lithium and placebo administration in aggressive children.

This study represents a secondary data analysis of two double-blind and placebo-controlled clinical trials of lithium, performed to contrast side effects associated with lithium administration to those associated with placebo. The sample consisted of 91 hospitalized children, aged 5.12 to 12.92 years (mean 9.16), diagnosed as having conduct disorder characterized by severe aggressiveness and explosiveness. Daily doses of lithium ranged from 250 to 2100 mg. During the entire treatment period, more side effects were seen in the lithium group than in the placebo group, whereas during the therapeutic dose period, the difference between side effects in the two groups diminished. The most common side effects seen exclusively with lithium administration included enuresis, fatigue, and ataxia. Increased aggressiveness was observed in 4 children who received placebo. Vomiting, headache, and stomachache were the most common side effects experienced by patients in both lithium and placebo groups. However, more patients experienced these side effects in the lithium group than in the placebo group.

Aggression↗
PubMed1992

Carbamazepine in hospitalized aggressive conduct disorder children: an open pilot study.

Ten subjects completed an open pilot study of carbamazepine in hospitalized aggressive and explosive children diagnosed as having conduct disorder. The subjects (9 boys, 1 girl) ranged in age from 5.25 to 10.92 years (mean = 8.27). Ratings were done at the end of a 1-week baseline period and after 3 weeks of treatment with carbamazepine. Ratings were carried out by multiple raters in several settings, using various rating instruments. The optimal daily doses of carbamazepine ranged from 600 to 800 mg (mean = 630); plasma levels at post-treatment rating ranged from 4.8 to 10.4 micrograms/mL (mean = 6.2). Administration of carbamazepine was associated with clinically and statistically significant declines in the target symptoms of aggressiveness and explosiveness. These results are promising and suggest that a critical assessment of the efficacy and safety of carbamazepine is warranted under double-blind and placebo-controlled conditions in this population.

Aggression↗
PubMed1991

Factors related to haloperidol response and dyskinesias in autistic children.

A secondary analysis of data pooled from three studies (Anderson et al. 1984, 1989; Campbell et al. 1978) was performed to identify variables predictive of haloperidol response in 125 autistic children, with ages ranging from 2.3 to 8.2 years. Mean behavioral improvement was greater under haloperidol treatment conditions than under placebo. Higher intelligence quotient (IQ) was predictive of reduction in behavioral symptoms under general conditions of haloperidol or placebo treatment, while older children were found to respond favorably to haloperidol itself. Under both haloperidol and placebo conditions, there was also a tendency for greater reduction in symptoms, in terms of raw score and percent change, for those with greater initial severity of illness. Results for initial severity of illness as a predictor of improvement generalized across a wide variety of behavior not specific to autism (e.g., hyperactivity and temper outbursts). However, mean behavioral improvement and its prediction with demographics for individuals tended to be more specific to symptoms related to autism per se. Reduction in symptoms during short-term haloperidol treatment was not found to be related to whether or not children developed dyskinesias in subsequent long-term haloperidol administration.

Autistic Disorder↗
PubMed1990

Naltrexone in autistic children: a double-blind and placebo-controlled study.

A double-blind, placebo-controlled study was designed to assess critically the effects of naltrexone on behavioral symptoms and learning in autistic children, and its safety. This is a preliminary report on 18 children, ages 3.08 to 7.99 years, who completed this ongoing study. Subjects were randomly assigned to naltrexone or placebo and received daily doses over a period of 21 days. Naltrexone was superior to placebo according to blind Clinical Global Consensus Ratings (unpublished scale). However, other behavioral rating measures did not confirm this result. There was only a suggestion that naltrexone reduced fidgety and hyperactive behavior and tended to alleviate overall symptomatology in older children. Naltrexone did not appear to affect discrimination learning. Results are preliminary and, owing to the small sample size, can be considered only suggestive until this study is completed or replication is obtained from independent research.

Autistic Disorder↗
PubMed1990

Saliva and serum lithium monitoring in hospitalized children.

Serum and saliva lithium levels are presented for 30 inpatients, ages 5.12 to 11.95 years, diagnosed as having conduct disorder of the undersocialized aggressive type. Maintenance doses of lithium carbonate ranged from 600 mg to 1,500 mg/day. Serum and saliva lithium levels were significantly correlated at optimal dose (r = .78, p less than .001) and overall (r = .83, p less than .001), lending support to the use of saliva lithium levels as an adjunct to serum lithium determinations. However, because saliva/serum lithium ratios reveal wide ranges between subjects, the use of saliva levels is limited, and laboratory assessments should be combined with careful clinical monitoring.

Child↗
PubMed1989

The effects of haloperidol on discrimination learning and behavioral symptoms in autistic children.

This double-blind and placebo-controlled clinical trial in autistic children had three objectives: (a) to replicate earlier findings that haloperidol administration is associated with a significant reduction of behavioral symptoms; (b) to further assess its safety when given on a short-term basis; and (c) to assess whether it has an effect on discrimination learning. Forty-five children, 2.02 to 7.58 years old (M = 4.49), completed this crossover design, with random assignment to treatment sequences. Haloperidol was shown to be a powerful therapeutic agent when administered for 4 weeks and free of side effects; at doses ranging from 0.25 to 4.0 mg/day (M = 0.844), there was a clinically and statistically significant reduction of a variety of symptoms. Under the given conditions, the children failed to learn on either haloperidol or placebo.

Autistic Disorder↗
PubMed1989

Naltrexone in autistic children: an acute open dose range tolerance trial.

The safety and efficacy of naltrexone was explored in an open acute dose range tolerance trial in 10 hospitalized autistic children, ages 3.42 to 6.50 years (mean, 5.04). Naltrexone was given in ascending doses: 0.5, 1.0, and 2.0 mg/kg/day. Behavioral side effects were observed as early as 1/2 hour after dosing. Ratings on the Children's Psychiatric Rating Scale showed that withdrawal was reduced across all three dose levels; administration of 0.5 mg/kg/day dose resulted in increased verbal production; and the 2.0 mg/kg/day dose resulted in reduction of sterotypies. Mild sedation of brief duration was the only side effect. Electrocardiogram, liver function tests, and all other laboratory studies remained unchanged throughout the study. These preliminary findings require replication in a larger sample of patients under double-blind and placebo controlled condition.

Autistic Disorder↗
PubMed1987

Lateralization of dichotic noise bursts: effect of onset and offset disparity.

Sound image position associated with the interaural onset or offset disparity of a signal was quantified by a scaling procedure in three experiments. Lateralization cues derived from the steady-state portion of the broadband noise signal that would support a specific image position were minimized by the use of independent noise sources for each ear. Onset disparities produced lateralization toward the ear at which the sound was presented first, while offset disparity produced lateralization toward the ear at which the sound remained on longer. Disparity was systematically varied between 0 and 10 ms and for a given disparity, a greater shift in the sound image position was obtained when the disparity was at the onset rather than the offset. The duration of the shorter signal ranged from 2.5-100 ms and for either onset or offset disparity, the image of stimuli of long duration tended to remain near the center of the head, while those of shorter duration could be moved to more extreme positions. In an attempt to rule out dichotic loudness cues as a basis for the lateralization associated with offset disparity, stimuli were presented with equal energy at each ear. Image position for equal energy was virtually identical to that for equal sound pressure, suggesting that loudness differences are not mediating lateralization associated with offset disparity.

Adult↗
PubMed1984

Behavioral efficacy of haloperidol and lithium carbonate. A comparison in hospitalized aggressive children with conduct disorder.

The efficacy and safety of haloperidol, lithium carbonate, and placebo were critically assessed in 61 treatment-resistant, hospitalized children aged 5.2 to 12.9 years with diagnoses of conduct disorder, aggressive type. In this double-blind and well-controlled study, the optimal dosages of haloperidol ranged from 1.0 to 6.0 mg/day and those of lithium carbonate from 500 to 2,000 mg/day. For the assessment of behavioral changes and untoward effects, various rating scales were used in different settings. Both haloperidol and lithium carbonate were found to be significantly superior to placebo in decreasing behavioral symptoms. Although both medications were clinically effective, haloperidol was associated more often with untoward effects than was lithium carbonate.

Aggression↗
PubMed1984

Frequency effects in backward masking.

Frequency effects in auditory backward masking were examined by psychophysically determining the thresholds of 0.5-, 1-, 3-, 5-, and 7-kHz sinusoidal probes followed by a broadband noise masker. For each probe frequency, backward masking decreased approximately exponentially as the temporal interval between the probe and masker was increased. The rate of this exponential decay increased with increasing probe frequency. This latter result is consistent with Duifhuis' [J. Acoust. Soc. Am. 54, 1471-1488 (1973)] theory which attributes backward masking to the temporal overlap of cochlear responses to the probe and masker.

Adolescent↗
PubMed1984

The influence of temporal cues on the strength of periodicity pitches.

Three different waveforms were generated from the same component frequencies by setting the phase of the components so they were either homophasic (all component sinusoids start at 0 degree), diphasic (sinusoids alternate between -45 degrees and + 45 degrees), or heterophasic (starting phase randomly selected). Listeners were asked to rate the saliency of all periodicity pitches they could detect in stimuli which contained 12 or more components at frequencies above the region where pitches were perceived . A major finding was that the highest ratings of fundamental frequency (f1) pitch "strength" were always obtained for homophasic waveforms, which among the test stimuli have the most abrupt envelope fluctuations. In contrast, diphasic and heterophasic waveforms, which have smoother envelopes, yielded lower pitch strength estimates at f1 and higher ratings two octaves above the fundamental. These data indicate that information concerning the stimulus waveform envelope influences the relative prominence of competing pitches evoked by periodicity pitch stimuli. However, no one-to-one correspondence between pitch and waveform periodicity is apparent.

Acoustic Stimulation↗
PubMed1984

Haloperidol in the treatment of infantile autism: effects on learning and behavioral symptoms.

In this double-blind, placebo-controlled study the administration of haloperidol resulted in significant decreases in behavioral symptoms and in general clinical improvement in 40 autistic children ages 2.33 to 6.92 years. Haloperidol also produced greater facilitation and retention of discrimination learning in the laboratory. No adverse effects were observed at therapeutic doses, which ranged from 0.5 to 3.0 mg/day or 0.019 to 0.217 mg/kg per day.

Autistic Disorder↗
PubMed1983

Tonal masking and frequency selectivity for the monaural and binaural hearing systems.

A series of masking experiments was performed with the aim of comparing frequency selectivity for the monaural and binaural systems. The masking stimulus used in this study combined a sinusoid, which was gated simultaneously with the signal, with a continuous broadband noise. Signal frequency was fixed at 500 Hz. In one condition, the tonal masker and noise were interaurally in phase and the signal was phase reversed. In a second condition, noise, tonal masker, and signal were presented to one ear alone. Signal thresholds were obtained as a function of masker frequency for these two conditions. After making an appropriate selection of noise levels, masking functions for the monaural and binaural system conditions were found to agree closely except for a region about their tips where the binaural condition was more detectable. Two possible interpretations of these results are discussed. Either the monaural and binaural systems contain filters each which have similarly shaped skirts, or the frequency selectivity observed under both diotic and dichotic conditions (for large frequency separations of masker and signal) reflect the operation of a common peripheral filter.

Acoustic Stimulation↗