Is a large head circumference a sign of autism?
Explore the source record for details and available documents.
Autistic Disorder↗
Biomedical subjects
E Fombonne
Publications and source records attributed to E Fombonne.
Psychological adjustment in a french cohort of type 1 diabetic children. PEDIAB Collaborative Group.
The aim of the study was to determine whether IDDM affects the course of psychological adjustment in youths. The study sample included 164 children with IDDM (mean age=10.2) and their parents compared to 164 healthy controls matched for age, sex and socioeconomic status. Adjustment was measured with the Child Behavior Checklist, a parental rating scale, validated and adapted for the French population. Two-way ANOVAs on CBCL scale scores showed that scores for both internalizing and externalizing problem behaviors and the total CBCL score were significantly raised in diabetic children (p<0.001). Further comparisons on the 8 narrow-band scale scores of the CBCL indicated increased scores for diabetic children on 6 dimensions. A significant Gender x Status (IDDM versus Controls) interaction was found, supportive of higher rates of aggressive behaviors amongst male diabetic children (p<0.01). Controlling for age, no correlation was found between CBCL total, internalizing and externalizing scores and duration of IDDM or HbA1c levels within the diabetic group. Psychological adjustment to chronic illness needs to be considered with respect to both normal developmental demands as well as in the context of the specific challenges posed by the disease.
Adolescent↗
[Developmental psychopathology. Basic science for child and adolescent psychiatry and psychiatry].
Although the developmental perspective is not new, developmental psychopathology has only recently become an interdisciplinary and integrative field of research for the understanding of normal and pathological development as well. There have been new findings during the past two decades in several areas: the individual and sex differences of certain disorders, continuity and change of behavior, risk factors and protective factors as well as turning points in development. Also, the current classification systems include the developmental perspective on a special axis devoted to developmental disorders. Nevertheless, there are still huge gaps in our knowledge in nearly all relevant fields that need to be filled in the future. On the other hand, the available knowledge has not yet been applied to diagnostic procedures, to therapeutic interventions, or to preventive measures.
Adolescent↗
The epidemiology of autism: a review.
BACKGROUND: There is some uncertainty about the rate and correlates of autism. METHOD: Twenty-three epidemiological surveys of autism published in the English language between 1966 and 1998 were reviewed. RESULTS: Over 4 million subjects were surveyed; 1533 subjects with autism were identified. The methodological characteristics of each study are summarized, including case definition, case-finding procedures, participation rates and precision achieved. Across surveys, the median prevalence estimate was 5.2/10000. Half the surveys had 95% confidence intervals consistent with population estimates of 5.4-5.5/10000. Prevalence rates significantly increased with publication year, reflecting changes in case definition and improved recognition; the median rate was 7.2/10 000 for 11 surveys conducted since 1989. The average male/female ratio was 3.8:1, varying according to the absence or presence of mental retardation. Intellectual functioning within the normal range was reported in about 20% of subjects. On average, medical conditions of potential causal significance were found in 6% of subjects with autism, with tuberous sclerosis having a consistently strong association with autism. Social class and immigrant status did not appear to be associated with autism. There was no evidence for a secular increase in the incidence of autism. In eight surveys, rates for other forms of pervasive developmental disorders were two to three times higher than the rate for autism. CONCLUSION: Based on recent surveys, a minimum estimate of 18.7/10000 for all forms of pervasive developmental disorders was derived, which outlines the needs in special services for a large group of children.
Adolescent↗
Are measles infections or measles immunizations linked to autism?
Explore the source record for details and available documents.
Autistic Disorder↗
Microcephaly and macrocephaly in autism.
Data from a series of 126 autistic children ages 2-16 years and referred to an Autism Diagnosis Unit in South-West France were examined. Macrocephaly (head circumference > 97th centile) was observed in 16.7% of the sample, a significantly higher proportion than that expected. Macrocephaly was more frequent among older subjects but was otherwise not associated with gender, developmental level, the presence of epilepsy or of medical disorders, or severity of autistic symptomatology. Microcephaly (head circumference < 3rd centile) was also significantly raised and found in 15.1% of the sample. Microcephaly was significantly associated with the presence of medical disorders. Results support those from recent studies suggesting a raised rate of macrocephaly in autism which, pooling published data, can be estimated to be 20%. It is argued that the raised incidence of microcephaly among low-functioning autistic subjects with medical disorders might have contributed to delay the recognition of an increased head circumference among a minority of subjects with idiopathic autism.
Adolescent↗
Psychopathology in adopted and nonadopted children: a clinical sample.
The relationships of adoptive status to presenting psychopathology and to demographic and psychosocial variables were examined in a large sample of children and adolescents who attended psychiatric outpatient services over a 14-year period. Adopted boys and girls were both at increased risk of disruptive behavior, including conduct disorders and ADHD. Age at time of adoption was not related to psychopathology.
Adolescent↗
Neurodevelopmental antecedents of early-onset bipolar affective disorder.
BACKGROUND: Developmental impairments have been identified as a risk factor for early-onset schizophrenia. Affective symptoms are more common in children and adolescents with disordered neurodevelopmental than in healthy controls. AIMS: To test the hypothesis that severe early-onset mood disorders are associated with developmental antecedents. METHOD: We retrospectively identified 38 adolescent cases (15 female, 23 male; mean age 14.4 years, range 11-18) who met ICD-10 Research Diagnostic Criteria for a manic episode, bipolar affective disorder or psychotic depression, and 41 controls (25 female, 16 male, mean age 14.2 years, range 11-18) with depression but without psychotic features. RESULTS: Cases were significantly more likely to have experienced delayed language, social or motor development (OR 5.5, 95% CI = 1.4-21.6, P = 0.01), in particular those who develop psychotic symptoms (OR 7.2, 95% CI = 1.8-28.6, P = 0.003). CONCLUSIONS: Compared to early-onset unipolar depression, neurodevelopmental antecedents are over-represented in early-onset bipolar disorder. The validity of this finding was supported by contemporaneous IQ scores that are not subject to the same potential biases as case-note ratings.
Adolescent↗
Inflammatory bowel disease and autism.
Explore the source record for details and available documents.
Autistic Disorder↗
Gender differences in rates and correlates of suicidal behaviour amongst child psychiatric outpatients.
Childhood suicide is an increasing problem in Western society. Identification of those at risk of suicidal behaviour is of priority to identify children with consequent mental suffering, and prevent successful attempts. The study determined factors associated with suicidal ideas, attempts or threats in 5426 psychiatric outpatients aged between 8 and 17 years who attended a British teaching hospital. Multivariate logistic regression analyses were performed by sex on the data from the standard department questionnaire. Substance abuse, depression and disturbed relationships with adults were predictors of suicidal behaviour for both sexes. For female subjects, antisocial behaviour was also associated. In girls alone, depression had significant interaction effects with substance abuse and conduct disorder. Possible reasons for these differences are discussed.
Adolescent↗
Increased rates of psychosocial disorders in youth.
The evidence for an increased incidence of rates of psychosocial disorders including depression, suicide, delinquency, eating disorders, and drug and alcohol abuse is summarized. Findings from prospective studies, family genetic studies, community surveys, repeated cross-sectional surveys, and data from mortality and police statistics suggest that the increase over time of several of these disorders is supported by epidemiological evidence, particularly for suicide, delinquency, addictive behaviors, and depression. Several studies also indicate that an earlier age of onset for these disorders is seen in the most recent birth cohorts, with most of these disorders having their onset in adolescent years. The implications of these findings for child psychiatric treatment and services are discussed.
Adolescent↗
Parental recognition of developmental abnormalities in autism.
In order to identify factors associated with the early detection and referral of children with pervasive developmental disorders, a sample of 82 consecutive referrals to an outpatient diagnostic service was studied. All children were thoroughly assessed with the Autism Diagnostic Interview (ADI), standardized psychological tests and direct observations. Data from the ADI on the first symptoms to arouse parental concern and on the first professional advice sought were analyzed. The mean age of children was 19.1 months (SD = 9.4) when the parents first became concerned, and the first professional advice was sought when children were 24.1 months old (SD = 11.7). The most common parental concerns were for speech and language development, followed by abnormal socio-emotional response, and medical problem or delay in milestone. In both bivariate and multiple regression analyses, the mean age of children at first parental concern and professional advice was significantly lower in the presence of mental retardation in the child, of an older sibling in the family, and of first parental concerns for medical problem/delay in milestone. More specific autistic behaviours, child's gender, social class and place of residence did not influence the age of recognition of the disorder in this sample. Health visitors and general practitioners were the first professionals contacted by parents. The implications of these findings for early detection and diagnosis of autism are discussed.
Age Factors↗
Tricyclic antidepressants in adolescent depression. A case report.
A boy aged 11 years 11 months, with normal premorbid personality, presented with a severe depressive episode with somatic and psychotic features. A clinical response to amitriptyline was complicated by ECG changes leading to the abrupt withdrawal of amitriptyline, with the development of a withdrawal syndrome. Further trials of antidepressant medication were unsuccessful, including paroxetine (clinical deterioration), lofepramine (ECG changes and clinical deterioration), and trazodone (priapism). Finally, a good clinical response to dothiepin augmented with lithium was achieved. ECG changes were assessed as being idiosyncratic responses to medication, rather than ischaemic in nature. A dose/response relationship with dothiepin was observed. All medication was successfully stopped after 26 months of treatment. Clinical phenomena relevant to the development of guidelines for use of tricyclic antidepressants in childhood and adolescence are discussed.
Amitriptyline↗
The Vineland Adaptive Behavior Scales: supplementary norms for individuals with autism.
Vineland Adaptive Behavior Scales Special Population norms are presented for four groups of individuals with autism: (a) mute children under 10 years of age; (b) children with at least some verbal skills under 10 years of age; (c) mute individuals who are 10 years of age or older; and (d) individuals with at least some verbal skills who are 10 years of age or older. The sample included 684 autistic individuals ascertained from cases referred for the DSM-IV autism/PDD field trial collaborative study and five university sites with expertise in autism. Young children had higher standard scores than older individuals across all Vineland domains. In the Communication domain, younger verbal children were least impaired, older mute individuals most impaired, and younger mute and older verbal individuals in the midrange. Verbal individuals achieved higher scores in Daily Living Skills than mute individuals. The expected profile of a relative weakness in Socialization and relative strength in Daily Living Skills was obtained with age-equivalent but not standard scores. Results high-light the importance of employing Vineland special population norms as well as national norms when evaluating individuals with autism.
Activities of Daily Living↗
Suicidal behaviours in vulnerable adolescents. Time trends and their correlates.
BACKGROUND: Suicide rates have increased over the past three decades, especially in young men. Depression, conduct disorder, crime and substance misuse have also increased. This study tested hypotheses on the possible links between the secular increase in the rates of these behaviours. METHOD: A data set on 6091 subjects aged 8-18 years (58.4% boys) referred to psychiatric services over a 21-year period (1970-1990) was used. A detailed analysis of a random sample of 80 case notes was conducted. RESULTS: Suicidal behaviours increased significantly among pubertal male adolescents only (n = 1313). In this sub-sample, substance misuse accounted for the increase over time. The rates of both suicidal behaviours and of substance misuse almost doubled between 1979 and 1990 in this patient group. The case note analysis showed that solvent and alcohol misuse had also increased over the study period. Moreover, among the subjects misusing substances, alcohol was the only substance with a strong and positive association with suicidal behaviours. Substance misuse pre-dated suicidal behaviours in most patients. CONCLUSIONS: A link has been found between the increase over time of suicidal behaviors in adolescent boys and a contemporaneous increase in substance misuse. The strength and direction of the association suggests that alcohol misuse is the causal factor.
Adolescent↗
An adoption study of depressive symptoms in middle childhood.
Several twin studies of children and adolescents have found significant heritability of depressive symptoms. In contrast, the sole adoption study of biologically related and biologically unrelated adopted siblings found no evidence for genetic influence. The present study attempts to confirm these results in middle childhood using two adoption designs. The sample, from the Colorado Adoption Project, included 180 adopted children (77 with adoptive siblings) and their biological and adoptive mothers, and 227 nonadopted children (93 with biological siblings) and their mothers. Mothers reported their own neuroticism, and children's depressive symptoms were reported by the parents and by the children themselves. For both the sibling adoption and the parent-offspring designs heritability was negligible, shared environment modest, and non-shared environment substantial, irrespective of child gender. Although the power of the sibling data is low, the combined findings from the two designs suggest that genetic effects on depressive symptoms in childhood may be somewhat smaller than previously estimated in twin studies.
Adoption↗
Elective mutism and chromosome 18 abnormality.
Explore the source record for details and available documents.
Child, Preschool↗
A cross cultural comparison of French and Dutch disturbed children using the Child Behaviour Checklist (CBCL).
Parents, mostly mothers, of French and Dutch children who had been referred to Mental Health Services, completed the CBCL to indicate the behaviour problems that their children suffered from. The 85 items which had been found in the USA to measure eight types of disturbed behaviour, called the cross-informant syndromes, were studied to see if a similar set of dimensions of disturbed behaviour would underlie the Dutch and French CBCL scores. Seven types of disturbance were found which corresponded to the equivalent cross informant syndromes, but thought problems had no similar sort of disorder amongst the Dutch and French children. It was found that only 43 items were necessary to measure these seven dimensions. It was concluded that despite differences in language, culture and the pattern of mental health services, the CBCL scores could be used to make meaningful clinical comparisons of psychiatric disturbances.
Adolescent↗