Biomedical subjects
B Rimland
Publications and source records attributed to B Rimland.
Controversies in the treatment of autistic children: vitamin and drug therapy.
A survey of approximately 4,000 questionnaires completed by parents of autistic children provided ratings on a variety of treatments and interventions. Among the biomedical treatments, the use of high-dosage vitamin B6 and magnesium (n = 318) received the highest ratings, with 8.5 parents reporting behavioral improvement to every one reporting behavioral worsening. Deanol (n = 121) was next most highly rated, with 1.8 parents reporting improvement to each one reporting worsening. Fenfluramine (n = 104) was third, with a ratio of 1.5:1. Thioridazine hydrochloride (Mellaril), by far the most often used drug on the list (n = 724), was fourth with a helped-worsened ratio of 1.4:1. The research literature on the use of vitamin B6-magnesium is briefly reviewed, and mention is made of recent findings regarding high-dosage folic acid in autism and biotin in Rett syndrome.
Megavitamins and hyperactivity.
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Hair mineral analysis and disruptive behavior in clinically normal young men.
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Agreement in diagnosis: clinical assessment and behavior rating scales for pervasively disturbed children.
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The effect of high doses of vitamin B6 on autistic children: a double-blind crossover study.
The authors used data from an earlier nonblind study to identify 16 autistic-type child outpatients who had apparently improved when given vitamin B6 (pyridoxine). In a double-blind study each child's B6 supplement was replaced during two separate experimental trial periods with either a B6 supplement or a matched placebo. Behavior was rated as deteriorating significantly during the B6 withdrawal.
Platelet uptake and efflux of serotonin in subtypes of psychotic children.
The only finding of a metabolic defect in psychotic children which has been replicated in a blind study is the discovery of an elevated efflux of serotonin from the platelets of children with early infantile autism (Boullin, Coleman, & O'Brien, 1970; Boullin, Coleman, O'Brien, & Rimland, 1971). The reported failure of Yuwiler, Ritvo, Geller, Glousman, Schneiderman, and Matsuno (1975) to replicate the Boullin et al. findings is attributable to differences in the method of selecting subjects. The Boullin et al. studies found that only children with classical infantile autism, as diagnosed by the Rimland E-2 check list, manifested the metabolic error. Since only 10% of psychotic children score in the autistic range on the check list, and since all children in the Yuwiler et al. study displayed the syndrome of "perceptual inconstancy," a syndrome inconsistent with "insistence on the preservation of sameness," an integral part of the syndrome of early infantile autism as scored on the E-2 check list, the failure of Yuwiler et al. to find elevated efflux in their sample was to be expected.
An analysis of autism in fifty males with the fragile X syndrome.
Fifty males with the fragile X [fra(X)] syndrome, which we consider synonymous with the Martin-Bell syndrome, were identified by a chromosome analysis of patients with developmental delays or mental retardation and family studies of known fra(X) pedigrees. These males were evaluated for autism using three criteria: 1) the DSM III diagnostic criteria for Infantile Autism; 2) the Autism Behavior Checklist (ABC); and 3) the Diagnostic Checklist for Behavior Disturbed Children, Form E2. Sixteen percent of patients fulfilled all of the DSM III criteria for Infantile Autism and an additional 30% fulfilled criteria for Infantile Autism Residual State. Thirty-one percent of patients had autism using the ABC checklist but none of the patients fit the classical Kanner syndrome as described by the E2 questionnaire. Some autistic traits were seen in almost all of the 50 fra(X) patients, including eye avoidance in 90%, handflapping, handbiting or handstereotypies in 88%, and language delays with language peculiarities, usually echolalic speech, in 96%. A pervasive lack of responsiveness was seen in 18% at their present age and in 44% in earlier childhood only. Autistic symptoms are common in the fra(X) syndrome. Therefore, any patient with developmental delays and autism or autistic manifestations should have a chromosomal analysis, including fra(X) examination.