Comments on "Olanzapine treatment of children, adolescents, and adults with pervasive developmental disorders: an open-label pilot study".
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Biomedical subjects
Publications and source records attributed to H B Demb.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Twelve of eighteen preschool children, previously diagnosed as having an atypical pervasive developmental disorder (APDD), using the third edition of the Diagnostic and Statistical Manual (DSM-III) of the American Psychiatric Association, were followed up 5 years later. The follow-up consisted of a pediatric neurodevelopmental evaluation and the administration of the Personality Inventory for Children (PIC), and a scale derived from the criteria for an autistic disorder (AD) in the revised third edition of the Diagnostic and Statistical Manual (DSM-III-R). The children continued to have significant emotional, social, and cognitive problems at follow-up. Almost all required some form of therapeutic intervention, and many received multiple interventions. A broader range of symptoms (including positive symptoms of schizophrenia and signs of affective and anxiety disorders) were noted. A comparison of DSM-III and DSM-III-R criteria for autism with this population revealed a lack of reliability in diagnoses between systems, both with respect to the more specific diagnosis ("autism") and the less specific atypical diagnoses. The authors discuss the implications of these findings with respect to the interpretation of future follow-up studies of autistic and atypical children.
Pediatricians and child psychiatrists encounter preschool children who are not autistic, but who have early deficits in both interpersonal and communication skills. Confusion exists over their diagnosis. Eighteen atypical children currently diagnosed as having an atypical pervasive developmental disorder are described. Areas discussed are social relatedness, speech and language, mental status, cognition, behavior, perception, social background, and medical/neurological status. These children constitute a distinct and frequently seen group within the spectrum of pervasive developmental disorders. Their characteristics are not currently captured within a diagnostic category in the Diagnostic and Statistical Manual, Third Edition (DSM-III), of the American Psychiatric Association. A revision of DSM-III, DSM-III-R, is currently being prepared. These children may not be captured within a diagnostic category in DSM-III-R. The distinguishing characteristics are onset before the age of three, language delay with disordered communication, social relationships characterized by variable relatedness, ritualistic or manneristic behaviors, the likelihood of hyperactivity and/or a short attention span, affective disturbances, excessive anxiety, and a thinking disorder or perseverative behaviors.
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Methods of psychotherapeutic intervention with developmentally disabled adolescents are described. The need to consider the cognitive deficits of these individuals is noted. Therapeutic techniques, utilizing primarily a direct teaching approach and involving a great deal of behavioral rehearsal and repetition, are described. Clinical material is presented to illustrate the use of these procedures when problematic behavior stems from a negative self-image, faulty judgement, poor impulse control, or a failure to attain emotional independence. It is suggested that the therapists must focus on the specific problematic aspects of the adolescent's life that are in need of change and should take a position as to the nature and direction of such change.
Individuals with mental retardation are almost twice as likely to demonstrate severe behavioral problems or symptoms of mental illness as are nonmentally retarded individuals. At present, however, the ability to diagnose a mental disorder in an individual with mental retardation is difficult, and instruments are needed to help facilitate this process. The Adolescent Behavior Checklist was developed with this purpose in mind. This self-report scale is used to assess the likelihood that an adolescent with mild mental retardation or borderline intelligence has a diagnosable mental illness. The 86-item yes/no self-report scale renders scores on eight subscales derived from DSM III-R. The checklist has been found to have good criterion and congruent validity and good test-retest reliability. Data regarding interrater reliability and the sensitivity and specificity of the scale are presented, as are implications for future research.