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Biomedical subjects

R P Barrett

Publications and source records attributed to R P Barrett.

At least 19 recordsLinked to original sources

A case report of naltrexone treatment of self-injury and social withdrawal in autism.

The endogenous opiate release theory of self-injurious behavior (SIB) was investigated through double-blind placebo-controlled administration of naltrexone hydrochloride (Trexan) to a 14-year-old autistic and mentally retarded male for treatment of severe SIB. Results yielded a marked decrease in SIB during two phases of active drug treatment, though SIB did not revert to originally observed placebo levels during a second placebo phase. An increase in social relatedness also was observed during phases of active drug treatment. Opiate theories of self-injury and the possible interrelationship of self-injury with pituitary-adrenal arousal and with social relatedness are discussed.

Adolescent

Social relatedness and autism: current research, issues, directions.

Social relatedness has recently become a primary focus of investigators in the field of autism. This shift to regarding disturbances in social relatedness as one of the defining manifestations of the disorder marks the movement of research on autistic disorder back to its origins, when Kanner first noted the "social and affective" symptoms of autism as pathognomonic. Currently, social impairment in autism is viewed as more pervasively characteristic of the disorder than any other single symptom. Further, there has been a recent proliferation of research designed to document the nature of social deficit in autism, and whether it is primarily affective, communicative, or cognitive in nature, or involves some combination of these three variables. This review summarizes recent research focusing on social relatedness in autism and discusses the implications of these findings.

Autistic Disorder

An observationally based rating scale for affective symptomatology in child psychiatry.

There is growing dissatisfaction with current methods for rating affective symptoms in children. We report findings from a preliminary psychometric study of an alternative approach, that of direct observational ratings. The Emotional Disorders Rating Scale (EDRS) is an observation-based instrument containing 59 items divided into eight subscales. The results of this study indicate that measurement of nonverbal components of affective symptoms in children is feasible. Interrater reliability and internal consistency of the EDRS subscales were high. The EDRS also has potential as a measurement of state-related changes in affective behavior and as a technique for examining treatment response.

Adolescent

Maternal and paternal alcohol consumption increase offspring susceptibility to Pseudomonas aeruginosa ocular infection.

Male rats that consumed liquid alcohol diets containing 35%, 17.5 or 0% ethanol-derived calories for a minimum of 3 weeks were bred to females which were fed similar diets during pregnancy. At approximately 50 days of age, offspring were challenged with 10 X 10(7) Pseudomonas aeruginosa onto the scarified cornea. The ocular response, evaluated macroscopically, for 3 weeks, revealed a significant dose-related effect of both maternal and paternal alcohol exposure. The higher the parental alcohol consumption the earlier and the more frequently the cornea of progeny perforated. There was no effect of sex of offspring or interaction between maternal and paternal factors. Histopathology confirmed the above data in that progeny of parents receiving 0% or lower-dose alcohol treatment had less severe corneal pathology than progeny of parents with higher alcohol doses.

Animals

Effects of naloxone and naltrexone on self-injury: a double-blind, placebo-controlled analysis.

The effects of naloxone hydrochloride (Narcan) and naltrexone hydrochloride (Trexan) on the pervasive self-injury of a 12-year-old autistic and mentally retarded girl were examined. Using separate multiple schedule (A1/B/B') and withdrawal (A-B-A1B-A1) single-subject experimental designs, we investigated the effects of both opiate antagonists in serial fashion under double-blind, placebo-controlled conditions. Results of the two studies showed that self-injury increased during the naloxone trial, whereas a decrease to near zero rates of self-injury was observed following treatment with naltrexone. The differential effect produced by the two drugs was discussed in terms of drug half-life and the operant conditioning theory of extinction. Follow-up data showing near zero rates of self-injury for 22 months following the conclusion of active treatment with naltrexone indicated that the intervention produced a durable result.

Autistic Disorder

Depression in mentally retarded children.

Thirty-one mentally retarded emotionally disturbed children, hospitalized within a university medical school's psychiatric intensive care program, were matched on age and sex and compared to 31 children from a normal school setting on depression. Measures included the Child Depression Inventory (CDI) and the Child Behavior Profile (CBP), with children being compared on total and subfactor scores for both measures. Depression and its various subcomponents were more prevalent in the mentally retarded group. There were no significant sex or age differences. Degree of overall psychopathology and depression were highly related. The relationship between criteria for depression on the CDI and CBC were also made. Correlational data showed a strong relationship between the cut-off scores for both measures, an important finding because they were based on norms established with children of normal intelligence. These data suggest that similarities exist between depression in mentally retarded children and those without such cognitive handicaps. The relationship of depression to other forms of psychopathology in the group of 31 emotionally disturbed mentally retarded children was also examined. A wide range of disorders including schizophrenia, aggression, withdrawal, and hyperactivity were evaluated. These are the first empirical data with mentally retarded children in the United States that are aimed specifically at evaluating depression, and should be useful to the clinicians in better understanding the phenomenon.

Adolescent

The assessment of mood and affect in developmentally disabled children and adolescents: the Emotional Disorders Rating Scale.

There is an unmet need for a reliable method of evaluating disorders of mood and affect in developmentally disabled children and adolescents. Such a measure is required for both accurate diagnosis and treatment monitoring in this population. An extensive review of existing assessment techniques confirms that: (a) current techniques for the evaluation of emotional disorders in cognitively normal individuals are inappropriate for most children with developmental disabilities; and (b) current instruments designed for the assessment of developmentally disabled children pay inadequate attention to affective symptoms. In this paper, the preliminary version of a new instrument, the "Emotional Disorders Rating Scale for Developmental Disabilities" (EDRS-DD), designed to evaluate mood and affect in children and adolescents with developmental disabilities, is presented. A pilot study indicates that interrater agreement is good.

Affective Symptoms

Use of the alternating treatments design as a strategy for empirically determining language training approaches with mentally retarded children.

The present study was conducted as a practical demonstration of the potential utility of the alternating treatments design (ATD) in determining the most efficacious language training approach with mentally retarded children. Two subjects were chosen who used single words to communicate but who did not combine words to form sentences. Two sentence triads consisting of four words each and rated as equivalent in difficulty were trained. Each triad had one sentence trained using oral speech methods, a second trained using total communication methods, and a third sentence trained using a "modified" total communication approach. Each training procedure involved chaining sentence parts, reinforcement, and prompting. Oral methods involved presenting vocal stimuli and requiring vocal responses. Total communication methods involved presenting vocal and signed stimuli and requiring vocal and signed responses. The "modified" total communication approach also involved presenting vocal and signed stimuli, but required only vocal responses. For the initial sentence triad with each child, an alternating treatments design was used to determine the relative efficacy of the three language training methods. This approach was repeated with a second sentence triad for each child using a multiprobe technique within a multiple baseline design. Results were consistent within each subject but differed across subjects, with one child benefitting most from total communication methods and the other benefitting most from oral speech methods. Results were discussed in terms of the utility of the alternating treatments design as a potentially useful aid to traditional decision-making in the selection of language training strategies commonly employed with mentally retarded children.

Adolescent

Behavioral treatment of chronic aerophagia.

Effects of various behavioral interventions on stereotyped aerophagic responding by a profoundly mentally retarded, 5-year-old girl were assessed. Aerophagic responding was defined as air swallowing with extreme stomach protrusion, followed by breath-holding. Observations of air swallowing, as well as physiologic measurements related to heart rate and respiratory patterns, were recorded across both baseline and treatment phases of the study. Multiple behavioral interventions were assessed within a laboratory setting using an alternating treatment design format, with the most effective treatment systematically extended to additional settings. Results indicated that a behavior modification treatment package was effective in suppressing the high frequency of this rare stereotyped act to near-zero rates.

Aerophagy