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Biomedical subjects

H Amorosa

Publications and source records attributed to H Amorosa.

At least 19 recordsLinked to original sources
PubMed2002

[Early childhood autism: age at onset and early regression].

OBJECTIVES: The age at onset of autistic symptoms and an early setback in the social or language development of children with early infantile autism has been discussed in the literature as a possible marker for a special subgroup. Information on the number of children with these symptoms varies widely in different reports. The purpose of this study is to analyse how often a late onset or a regression in social or language behaviour are reported in a clinical sample and how they are related to other abnormalities found in these children. METHODS: The files on 101 children seen in a specialised outpatient department since 1993 and diagnosed with early infantile autism were analysed. Information on the six axes of the multiaxial classification, the age at onset of symptoms and at setback in social or language development was extracted. RESULTS: Of these 101 children, 75% were described as being different from other children from the beginning. Fourteen showed a regression in social behaviour and 21 a regression in language development. These symptoms did not correlate with intelligence or the status of language development at the time of the assessment. Children with a setback more frequently had epileptic seizures than did children without a setback. CONCLUSIONS: The accumulated data permit the hypothesis that children with a late onset of autistic symptoms or a regression constitute a special subgroup within the group of children with early infantile autism. These symptoms should lead to an intensive diagnostic process in order to exclude epileptic abnormalities.

Autistic Disorder↗
PubMed2001

The use of the ADI-R as a diagnostic tool in the differential diagnosis of children with infantile autism and children with a receptive language disorder.

Children with infantile autism and children with a specific receptive language disorder often show similar behavioural problems, making the differentiation between these two diagnostic categories difficult. The purpose of this study is to evaluate the usefulness of parental information in the differential diagnosis of the two types of disorders mentioned above. Sixteen children with a receptive language disorder and 11 children with infantile autism participated in the study. All children had normal non-verbal IQs. The ADI-R (Autism Diagnostic Interview-Revised) was performed with all children. The results showed that the ADI-R items reflecting behavioural features at pre-school age (age range 4-5 years) were better suited to differentiate the groups than the items reflecting behavioural features at the time of the investigation (mean age: 9 years). The items on the dimension "Reciprocal social interaction" and "Communication and language" discriminated the groups better than the items of the dimension "Restricted interests". According to the ICD-10 algorithm of the ADI-R one child with autism and one child with a receptive language disorder were falsely classified. These false classifications were mainly due to a distorted parental perception of the child's behaviour. The ADI-R is a useful tool in the differential diagnosis of developmental disorders.

Algorithms↗
PubMed2001

Evaluation of attention problems in children with autism and children with a specific language disorder.

Children with autism and children with a specific language disorder show additional attention deficits. The literature on the neuropsychological investigation of attention in both groups of children suggests that the nature of their attention problems might be different. The purpose of this study is to examine the attention test profiles in these two groups of children with developmental disorders. Nineteen children and adolescents with autism, 17 subjects with a specific language disorder and 19 control subjects participated in the study. Non-verbal intelligence was normal for all subjects. The "Testbatterie zur Aufmerksamkeitsprüfung" was administered to all subjects. This instrument provides the possibility to examine a wide range of attention functions and executive functions. The results showed that the autistic individuals had deficits in executive functions, whereas the language impaired children had deficits in auditory sustained attention, in auditory selective attention, and in the domain of executive functions. It is concluded that although both groups of developmentally impaired subjects showed attention problems, the deficits are not the same in both groups. The different neuropsychological profiles probably reflect different mechanisms in the pathogenesis of the attention deficits in both types of developmental disorders.

Adolescent↗
PubMed2001

[Behavioral problems in children with specific and pervasive developmental disorders, evaluated with the psychopathology assessment scale (AMDP)].

Children with specific developmental disorders of speech and language have an increased rate of psychiatric disorder compared to children developing normally. Children with early infantile autism show psychopathological symptoms in addition to those that are required for the diagnosis. These are often important in daily dealings with the children. As part of a larger study 4 groups of school age children (21 with normal development, 18 with an expressive language disorder, 21 with a receptive language disorder and 11 children with early infantile autism) were rated according to the psychopathological documentation for children (AMDP) within the assessment situation and according to reports of the behaviour outside. Several items were added to include symptoms that are not rated in the present documentation. Significant differences in the means were found between the group of children with autism and the control group. The children with language disorder showed a high variance which was interpreted as a sign for a heterogeneous group. Several of the added items improve the documentation of psychopathological findings in young school children.

Age Factors↗
PubMed2000

Diagnostic assessment of communicative and interactive behaviours in children with autism and receptive language disorder.

Children with autism and children with a severe specific receptive language disorder both show clear deficits in communicative language skills and in social relationships. In this study the usefulness of the Autism Diagnostic Observation Schedule (ADOS) in the differential diagnosis between these two groups of developmentally impaired children is assessed. 11 children with early infantile autism and 20 children with a specific receptive language disorder participated in the study. 18 children with an expressive language disorder were used as a control group. The ADOS was individually administered to all children by the same examiner. The results showed that on most of the ADOS measures the autistic children were clearly more deviant than the language impaired children. There were no significant differences between the two groups of language impaired children. Eight out of 11 autistic children reached the defined cut-off values on the measures "language and communication" and "social interaction" of the ADOS algorithm, whereas only three autistic children did so on the measure "stereotyped behaviour". None of the language-impaired children reached the cut-off values on more than one measure. The ADOS allowed for good assessment of certain types of behaviour. However, to confirm the diagnosis of infantile autism, additional information from parents is required.

Autistic Disorder↗
PubMed1999

Evaluation of emotional and behavioral problems in language impaired children using the Child Behavior Checklist.

Speech and language impaired children are at special risk for developing psychiatric disorders. Attention deficit, aggressive behaviour as well as overanxiety and excessive shyness have been reported in speech and language impaired children. The purpose of this study was to determine how the Child Behavior Checklist (CBCL) could be used as a screening instrument in language impaired children. In a sample of 83 language impaired children, emotional and behavioural problems were evaluated using the CBCL. Independent of this assessment, DSM-IV diagnoses were established for all children. Sixty-six of the 83 children had a psychiatric diagnosis. The use of the Total Behavior Problem score (TBP) as a global measure of behavioural disturbance showed that children with a psychiatric diagnosis had significantly higher scores on the TBP score than children without a psychiatric diagnosis. The specificity of the TBP was 88.2%, the sensitivity 75.8%, and the false classification rate 21.6%. The most frequently reported behavioural disturbances were problems on scale VI ("Attention Problems"-39 children) and on scale I ("Withdrawn"-32 children). A small group of children with a receptive language disorder and pronounced compulsive behavioural problems had elevated scores on scale V ("Thought Problems").

Affect↗
PubMed1999

[Applicability of the Child Behavior Checklist in developmentally delayed children].

OBJECTIVES: The Child Behavior Checklist is used to assess behavioral problems in a large unselected sample of children. In the present study we assess the usefulness of the CBCL in the evaluation of the typical behavioral problems usually reported in children with developmental disorders. METHODS: We examined two groups of children which both had language or communication problems. The first group consisted of 34 children with infantile autism, the second group consisted of 34 age-, sex- and IQ-matched children with a specific developmental speech and language disorder. The CBCL was filled out by the parents in both groups as part of the routine diagnostic procedures. RESULTS: Half of the language-impaired children have Total Behavioral Problem scores within the clinical range. Problems are mainly reported on the scales: "Attention Problems", "Social Problems" and "Withdrawn". Two-thirds of the autistic children have deviant scores on the syndrome scales mentioned above. 32 out of 34 autistic children score within the clinical range on the scale "Thought Problems", whereas only one language-impaired child does so. Single item analysis shows a high prevalence of developmental problems (speech problems, enuresis ...) in both groups. CONCLUSION: The CBCL records characteristic behavioral problems in children with developmental disorders. The problematic behaviors are shown on the syndrome scale level as well as on the single item level. Children with developmental disorders and high scores on the "Thought Problems" scale of the CBCL should be evaluated for the presence of a possible pervasive developmental disorder.

Adolescent↗
PubMed1999

[Exclusion of receptive speech disorders with the ADOS (Autism Diagnostic Observation Schedule)].

OBJECTIVE: The purpose of our pilot study was to assess the reliability and diagnostic validity of the Autism Diagnostic Observation Schedule (ADOS). The usefulness of the schedule in the differentiation between children with autism and children with a severe specific receptive language disorder is examined. METHOD: Eight boys with early infantile autism and eight age- and IQ-matched boys with a specific receptive language disorder were examined with the ADOS. The reliability of the instrument was assessed using the ratings of eight pairs of raters. The agreement between diagnostic classification based on the ADOS ICD-10 algorithm and the independent clinical psychiatric diagnosis of two experts was used as the measure of validity. RESULTS: The reliability of the different ADOS items proved to be good among experienced raters. Various ADOS items clearly discriminate both groups. Using the ADOS ICD-10 algorithm, the clinical diagnosis of infantile autism could be confirmed for five of the eight children in this group. None of the children with the clinical diagnosis of a receptive language disorder was identified as autistic according to the algorithm. CONCLUSIONS: In the hands of experienced raters the ADOS is a reliable diagnostic instrument. It can support the differentiation between autism and specific receptive language disorder, but additional parent information is needed to confirm the diagnosis.

Auditory Perceptual Disorders↗
PubMed1999

[Behavior problems in language-impaired children: therapy evaluation using child behavior checklist].

Speech and language impaired children often show accompanying behavioral and emotional problems, putting an additional burden on their developmental course. In a sample of 57 children with a specific speech and language disorder we evaluated the behavioral changes after therapeutic intervention. The children got intensive treatment for about 15 months. Before the beginning of the treatment, all children were assessed using clinical psychiatric interviews and observations and were diagnosed according to the multiaxial classification scheme. The CBCL was filled in by the same parent before and after the treatment program. The Total Behavior Problem Score was used to assess changes in behavioral problems. The school type as well as the still necessary therapeutic interventions after the completion of the treatment program were used as global measures of psychosocial adaptation. 45 of 57 children had a psychiatric diagnosis on axis 1 of the multiaxial classification scheme. Hyperkinetic disorder, with or without conduct disorders were the most commonly given diagnoses, in addition to emotional disorders and adjustment problems. Before treatment, the children with a psychiatric diagnosis had higher scores on the Total Behavior Problem Score than the children without a psychiatric diagnosis. The children with psychiatric problems showed a significant decrease in the Total Behavior Problem Score of the CBCL. Although the children with a conduct disorder also showed improvement after treatment, their CBCL scores remained high. The stability of their problems was associated with a worse school prognosis and with further institutional care after the end of the treatment.

Adolescent↗
PubMed1998

[Differential language comprehension disorders: results of an explorative study].

OBJECTIVES: Deficits in the expressive language abilities of children are easily observed. Thus these children usually are detected early and receive appropriate professional help. Receptive language abilities are much more difficult to assess, so that deficits either go unnoticed or often are not treated early. METHODS: In a population of 100 children examined between 1993 and 1995 in the outpatient department for speech, language and behavior problems at the Heckscher Klinik in Munich-Solln and diagnosed as having clinically relevant deficits in language comprehension, we determined the ICD-10 diagnostic category into which the symptom "language comprehension deficit" would best fit. RESULTS: 16 children exhibited language comprehension deficits that were part of a general mental retardation, three other children were diagnosed as having a pervasive developmental disorder. 81 children fulfilled the clinical ICD-10 criteria of a specific receptive language disorder, often in combination with a hyperkinetic syndrome or an emotional disorder. For 42 of these children this diagnosis also was confirmed by test results showing a discrepancy of one standard deviation between the language comprehension test and the non-verbal IQ. The value of language tests for the diagnosis of specific developmental speech and language disorders is discussed.

Adolescent↗
PubMed1994

Use of tiapride on stuttering in children and adolescents.

Reported here is the therapeutic efficacy of Tiapride with 10 10- to 17-yr.-old patients afflicted with severe stuttering problems. During the 20-wk. open, controlled study (baseline, low dose of Tiapride, high dose of Tiapride, follow-up observation without medication) the stuttering in various speech situations decreased markedly. No substantial change in different parameters of acoustic analysis and psychopathological characteristics accompanied the reduction in stuttering when group data were compared although positive effects concerning these variables could be seen in some cases. Several conclusions based on these results are presented. One assumed effect of the medication is improvement of central nervous regulatory mechanisms of speech motor coordination. Further, the value of the medication Tiapride in comprehensive stuttering therapy is discussed.

Adolescent↗
PubMed1993

Is there a dissociation between emotional feelings and emotional signs in autism?

There is evidence that autistic persons are deficient both in the expression and recognition of emotion. Emotions are viewed here as in part genetically determined, inborn behaviours with great importance for social regulations. Both in phylogenetic and in ontogenetic development there is a transgression from emotion-bound or signal-reflex-like behaviour chains towards an experience-based coupling of emotional signals with events lying outside emotional exchanges. We conjecture that in childhood autism there is a deficit in linking biologically based emotional signals to emotional experiences and/or a deficit in linking these signals to a third element. Mesocortical areas with close connections to the limbic systems appear to be involved.

Adolescent↗
PubMed1990

Psychiatric disorders in children and adolescents: results of the ICD-10 field trial.

Of the numerous changes made in the classification of psychiatric disorders in children and adolescents in ICD-10 the most important are described. In an evaluation of the revised scheme, 7 raters from 2 facilities classified 40 case histories with both ICD-10 and ICD-9 codes. For ICD-10 and 4 character codes the level of agreement was 56% (ICD-9: 60%). As expected, 3-character codes yielded better agreement (ICD-10: 71%; ICD-9: 72%). Within-facility agreement was roughly the same for each. The lowest levels of agreement for a given category were for mixed disorders of conduct and emotions (F92) and depressive disorders (F31, F43). The reasons for this are discussed.

Adolescent↗
PubMed1990

Phenomenal and operationalized classification of psychiatric disorders in children and adolescents with ICD-9 and ICD-10, on the basis of a field study.

In connection with the implementation of ICD-10, a further multicenter field study was conducted with 33 raters from 9 facilities for child and adolescent psychiatry. Each rater evaluated the same 29 case studies, resulting in a total of 957 ratings. When coding was done with 4-character ICD-10 codes interrater agreement on a given diagnosis averaged 50.3% (ICD-9: 47.3%); with 3-character ICD-10 codes the figure was 61.0% (ICD-9: 66.5%). When alternative diagnoses were also considered, agreement improved by about 7% (4-character codes) and 7.4% (3-digit codes), respectively. The highest levels of agreement were found for monosymptomatic disorders (F94, F95 and F98), the lowest for mixed disorders of conduct and emotions (F92) and depressive disorders (F31, F43). These results indicate that, on the whole, psychiatric disorders in children and adolescents can be classified reliably with the ICD-10, even when the raters have had no experience with the scheme.

Adolescent↗