PubMed Health⌕ Search

Biomedical subjects

E Schopler

Publications and source records attributed to E Schopler.

At least 19 recordsLinked to original sources
PubMed1992

Classification of pervasive developmental disorders: some concepts and practical considerations.

Classifications have to meet a variety of purposes. Clinical and research needs are different and there is much to be said for separate clinical and research schemes. Care is needed to ensure that classifications provide an appropriate medium for teaching about diagnosis and do not cause difficulties when used as a "passport" to resources. Principles of classification are considered in relation to the need to take course, as well as symptomatology, into account, and with respect to the neuropsychiatric interface. The value of a multiaxial approach is noted. The pros and cons of autism and pervasive developmental disorders (PDD) as an overall descriptive term, of lumping or splitting, and of different choices with respect to PDD subcategories are discussed.

Autistic Disorder↗
PubMed1992

Comparison of DSM-III-R and childhood autism rating scale diagnoses of autism.

The purpose of this study was to clarify the issue of whether DSM-III-R (American Psychological Association [APA], 1987) over- or underdiagnoses autism by comparing this diagnostic system to a well-established objective measure of diagnosis, the Childhood Autism Rating Scale (CARS). A secondary goal was to determine which of the 16 criteria are the best discriminators of autism. DSM-III-R, CARS, and clinical diagnoses of 138 consecutive admissions to a statewide program for the diagnosis and treatment of autistic and related communication-handicapped individuals (Division TEACCH in North Carolina) were compared. Results indicated a generally high degree of agreement on the diagnosis of autism using the three systems. Within this treatment-oriented program, the CARS and clinical ratings diagnosed a greater number of cases as autistic than did the DSM-III-R criteria, suggesting that DSM-III-R slightly underdiagnosed autism. The criteria that most strongly related to the diagnosis of autism regardless of the system were lack of awareness of others, abnormal social play, an impaired ability to make friends, abnormal nonverbal communication, stereotypic body movements, and restricted range of interests.

Adolescent↗
PubMed1992

A follow-up study of high-functioning autistic children.

Fifty-eight high-functioning autistic children were assessed during preschool and early school years and followed over a period of 8 years. Early and current psychometric and language tests, parent interviews concerning autistic symptomatology, and direct observations were examined as predictors of the Vineland Adaptive Behavior Scales and scores on standardized achievement tests. Verbal skills emerged as the strongest predictor of social-adaptive functioning. Clear, positive relationships also emerged between intellectual functioning, and academic attainment. Early non-verbal IQ also showed a positive relationship with outcome. Academic performance appeared considerably stronger than in earlier studies.

Achievement↗
PubMed1991

Pre- and perinatal factors in high-functioning females and males with autism.

Pregnancy and delivery complications as indicated in medical records and maternal reports for 23 high-functioning autistic females and 23 high-functioning males of similar IQ and age were compared with those of 54 of their normally developing siblings. Autistic subjects of both sexes had higher non-optimality scores than their siblings. Much of this difference was accounted for by a higher incidence of firstborns and fourth- or later-borns in the autistic group. Of factors found in previous research with mentally handicapped, autistic samples, only estimated weeks of gestation greater than 42 occurred more often in autistic subjects than siblings. The only sex difference specific to the autistic group was that autistic males came from larger families than females. These data provide slight support for the contribution of nonspecific pre- and perinatal factors to other etiological bases of autism. It is proposed that pre- and perinatal factors may play less of a role in autism in high-functioning individuals than suggested in studies of autism associated with severe retardation.

Adolescent↗
PubMed1990

Past and present trends in residential treatment.

The history of residential care for those with autism and other developmental handicaps is summarized for the past 200 years. Residential trends toward community integration in the past three decades are traced for autism in general and for one state institution in particular. Parallel cycles for residential care from previous periods are identified. Some negative side effects of current trends are identified if the needs of the population with handicaps and the community are not better integrated in the future.

Autistic Disorder↗
PubMed1990

Critical issues in the residential care of people with autism.

There is an ever-growing need to expand both the number and range of residential services for individuals with autism while developing strategies for assuring the quality of these programs. Future program development will be facilitated by an empirical approach to the critical elements that have been identified throughout the articles in this issue.

Autistic Disorder↗
PubMed1989

Autism diagnostic observation schedule: a standardized observation of communicative and social behavior.

The Autism Diagnostic Observation Schedule (ADOS), a standardized protocol for observation of social and communicative behavior associated with autism, is described. The instrument consists of a series of structured and semistructured presses for interaction, accompanied by coding of specific target behaviors associated with particular tasks and by general ratings of the quality of behaviors. Interrater reliability for five raters exceeded weighted kappas of .55 for each item and each pair of raters for matched samples of 15 to 40 autistic and nonautistic, mildly mentally handicapped children (M IQ = 59) between the ages of 6 and 18 years. Test-retest reliability was adequate. Further analyses compared these groups to two additional samples of autistic and nonautistic subjects with normal intelligence (M IQ = 95), matched for sex and chronological age. Analyses yielded clear diagnostic differences in general ratings of social behavior, specific aspects of communication, and restricted or stereotypic behaviors and interests. Clinical guidelines for the diagnosis of autism in the draft version of ICD-10 were operationalized in terms of abnormalities on specific ADOS items. An algorithm based on these items was shown to have high reliability and discriminant validity.

Adolescent↗
PubMed1989

The Adolescent and Adult Psychoeducational Profile: assessment of adolescents and adults with severe developmental handicaps.

The purpose of this study was to determine the reliability and validity of the Adolescent and Adult Psychoeducational Profile (AAPEP), an assessment instrument designed for adolescents and adults with severe developmental handicaps. Subjects were 60 adolescents and adults, 30 with autism and 30 with mental retardation but without autism. The groups were matched on age and IQ. Results suggested high interrater reliability on all function areas of the AAPEP (Vocational Skills, Independent Functioning, Leisure Skills, Vocational Behavior, Functional Communication, Interpersonal Behavior) and on all three scales (Direct Observation, Home, School/Work). Validity measures suggested that the recommendations generated from the AAPEP were viewed by blind experts as more helpful than those already generated for the individual clients and contained in their Individual Education Programs (IEPs) or Individual Habilitation Plans (IHPs). Informal measures indicated that parents and/or group home staff also found AAPEP recommendations helpful. Finally, reliability and validity measures were also encouraging for moderately and severely handicapped adolescents and adults without autism. The AAPEP appears to be an effective new instrument for those working with older handicapped clients.

Activities of Daily Living↗
PubMed1989

The role of age at assessment, developmental level, and test in the stability of intelligence scores in young autistic children.

Longitudinal comparisons were made of intelligence and developmental quotient (IQ/DQ) scores for three age groups of 70-72 autistic children aged 2 to 3, 4 to 5, and 6 to 7 years at initial assessment and reassessed at least 2 years later. Stability and predictability over a mean follow-up period of 5 years were related to age, developmental level, and test used at initial assessment. IQ/DQs during preschool years were quite stable and predictive of later IQ scores, except when early scores on the Bayley Scales of Mental Development were compared with later scores on performance or nonverbal tests. As for other populations, predictability for young autistic children was strongest when the same test was used at both assessments, and when children were 4 years or older at initial assessment.

Age Factors↗
PubMed1989

Relation of behavioral treatment to "normal functioning": comment on Lovaas.

Our commentary is a critique of the Lovaas (1987) study on the outcome of intensive behavioral intervention with young autistic children. Problems in the following aspects of the study are reviewed: (a) the choice of outcome measures, (b) the criteria for subject selection and the intellectual level of the subjects, and (c) the method for assigning subjects to control groups. Based on the available data, we posit that it is not possible to determine the effects of the intervention.

Adaptation, Psychological↗
PubMed1989

Use of the childhood autism rating scale with autistic adolescents and adults.

The suitability of the Childhood Autism Rating Scale (CARS) for diagnosing adolescents and adults with autism was tested and CARS ratings over time were examined to assess how the characteristics of autism change during adolescence. Subjects (N = 89) had been rated with the CARS before age 10 and again after age 13. A cutoff score of 27 was used; of 59 diagnosed as autistic prior to age 10, 92% were diagnosed as autistic after age 13. Moreover, 9 CARS categories showed significant improvements over time; only 1 showed a significant decrement. The CARS is thought to be a useful screening device for adolescents and adults with autism. Implications of this research for the understanding of autism and how it changes with development are discussed.

Adolescent↗
PubMed1989

Stability of assessment results of autistic and non-autistic language-impaired children from preschool years to early school age.

The predictability, consistency in group means, and intra-individual stability of developmental quotients and performance IQs were assessed from preschool to school age for 71 autistic children and 71 non-autistic communication-handicapped children, matched on chronological age, sex and initial performance IQ/DQ. DQs/performance IQs at age 4 yrs were found to be highly correlated with performance IQ at age 10 yrs for both groups. Absolute difference scores and group means were also equivalent for both samples, with no difference in patterns of change or the relationship between performance IQ and language status, as measured on the PPVT. Differences between diagnostic groups occurred only for scores on the Vineland Social Maturity Scale and the relationship between these scores and IQ.

Autistic Disorder↗
PubMed1988

Factors relating to age of onset in autism.

We examined the distribution of ages of onset of autism and related communication handicaps and assessed factors related to age of onset. Subjects were approximately 1,800 children seen at Division TEACCH (Treatment and Education of Autistic and related Communication handicapped CHildren) since 1970. Exact numbers of subjects varied with different analyses due to missing data. Data were gathered through direct assessment, interview, and questionnaire. Seventy-six percent of autistic children were identified by parents by 24 months of age, and 94% by 36 months. Families reporting early onset tended to seek help sooner and to be seen by TEACCH sooner. Early onset was most clearly related to severity as measured by IQ and ratings on the Childhood Autism Rating Scale (Schopler, Reichler, & Renner, 1986). The findings support the treatment of age of onset of autism by DSM-III-R (American Psychiatric Association, 1987).

Age Factors↗
PubMed1987

Autism and pervasive developmental disorders: concepts and diagnostic issues.

The purpose of this report is to bring up to date available information on the defining features and diagnostic issues relating to autism and related disorders. We review the validity of the syndrome based on our last review (Rutter, 1978; Schopler, 1978). Subsequent data have produced refinement in our understanding of both diagnostic criteria and the nature of the basic deficit. Controversies over both the boundaries and the heterogeneity within the autism syndrome are evaluated according to available evidence. Diagnostic rating instruments for expediting systematic sample selection are critiqued, and leads for new research directions are suggested.

Autistic Disorder↗
PubMed1985

Differences in sex ratios in autism as a function of measured intelligence.

Results from analyses of sex ratios as a function of IQ are presented for 623 autistic children (487 males, 136 females) and 506 nonautistic, communication-handicapped and behavior-disordered children (374 males, 132 females). Proportionately more autistic females were found to have IQs of 34 or below than above 34. However, a linear trend of an increasing number of males with increasing intelligence was found only for nonautistic subjects. The relevance of these findings to genetic factors and the heterogeneity of autism is discussed.

Autistic Disorder↗