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Biomedical subjects

S Einfeld

Publications and source records attributed to S Einfeld.

11 recordsLinked to original sources
PubMed2006

Behaviour and emotional problems in toddlers with pervasive developmental disorders and developmental delay: associations with parental mental health and family functioning.

BACKGROUND: Behavioural and emotional problems occur at a high rate in children and adolescents with intellectual disability, often from a young age. Some studies have indicated that children and adolescents with autism present with even higher rates. Less is known about the presentation, development and family impact of these difficulties in young children with autism. This study aimed to explore these issues in toddlers with pervasive developmental disorders (PDDs), those with delay without a PDD, and their families. METHODS: Participants were 123 children aged 20-51 months, referred to a developmental assessment clinic. Parents completed a checklist on child behavioural and emotional problems, and individual questionnaires on family functioning, their own mental health, and stress in relation to parenting their child. The child's language and cognitive skills, adaptive functioning and behaviour were assessed by standardized measures. Measures were repeated 1 year postdiagnosis. Behavioural and emotional problems in young children with a PDD were compared with those in children with developmental delay without a PDD, and their impact on parental outcomes explored over time. RESULTS: Initial and follow-up measures of child behaviour and emotional problems, parent mental health problems, parent stress and family functioning were significantly correlated, providing some evidence of stability over time. Child emotional and behavioural problems contributed significantly more to mother stress, parent mental health problems, and perceived family dysfunction than child diagnosis (PDD/non-PDD), delay or gender. Compared with mothers, all fathers reported significantly less stress in relation to parenting their child. CONCLUSION: Results highlighted the importance of addressing emotional and behavioural problems in very young children with autism and/or developmental delay. The need for early support and intervention for mothers, fathers and families in this context was also evidenced. As research has shown that behavioural and emotional problems persist into adolescence and young adulthood, understanding of these issues in very young children and their parents has important implications for intervention and long-term outcomes.

Adult↗
PubMed2000

Genes on the X chromosome are important in undiagnosed mental retardation.

The clinical genetic diagnosis was reviewed in 429 subjects with intellectual disability in the Australian Child and Adolescent Development (ACAD) study of behavioural problems. With minor differences, the overall "general distribution by causation" was similar to that to that found by the Consensus Conference of the American College of Medical Genetics in 1995. There was a significant male excess in the whole series which was shown to reside in those with "autism," those with undiagnosed nonsyndromic mental retardation (NSMR) and those with X-linked monogenic disorders. It is argued that a substantial proportion of undiagnosed NSMR is caused by genes on the X chromosome. Some of the practical problems of assigning individuals to diagnostic groups are discussed.

Adolescent↗
PubMed2000

The trajectory of psychiatric disorders in young people with intellectual disabilities.

OBJECTIVE: This study addresses the question of how prevalence and patterns of psychiatric disorder change from childhood to adolescence in young people with intellectual disability (ID). METHOD: A representative epidemiological sample of 582 young people with ID aged 4-19 years was surveyed in 1991-1992 and again in 1995-1996. The main measure of psychiatric disturbance was the developmental behaviour checklist (DBC), a 96 item parent/carer completed questionnaire with robust psychometric properties which provided an overall score, 6 subscale or syndrome measures of psychiatric disturbance and determined caseness. RESULTS: The findings confirmed that about 40% of young people with ID had psychiatric disorders which persisted over 4 years. Clinically significant change in symptoms with either deterioration or improvement occurred in around 14% of the sample. CONCLUSION: Psychiatric disorder is 3-4 times more prevalent in young people with ID than in the general population. Less than 10% of these young people receive specialist services for a problem which is numerically as large as schizophrenia.

Adolescent↗
PubMed1999

Longitudinal course of behavioral and emotional problems in fragile X syndrome.

We describe a follow-up of a study of behavior and emotional problems in a cohort of young people with Fragile X syndrome over 7 years. The study demonstrates that there is substantial persistence of the overall level of behavior and emotional problems. However, there are changes in certain types of behavior. Scores on the "disruptive" subscale of the Developmental Behavior Checklist decline significantly, whereas those on the "antisocial" subscale increase significantly. These changes parallel those seen in a large epidemiological control sample of young people with intellectual disability due to other causes. Further, two individual behaviors that distinguished the Fragile X individuals from the control individuals in the original study, namely "shy" and "avoids eye contact," continue to do so 7 years later.

Adolescent↗
PubMed1996

Combined pharmacotherapy or polypharmacy?

A case of possible 'serotonin syndrome' is reported. The use of combinations of psychotropic medications to treat children with severe behaviour disorders is an increasing trend among paediatricians and child psychiatrists. Some hazards as well as possible advantages are discussed.

Aggression↗
PubMed1994

Neural networks and psychiatry: candidate applications in clinical decision making.

Neural networks comprise a fundamentally new type of computer system inspired by the functioning of neurons in the brain. Such networks are good at solving problems that involve pattern recognition and categorisation. An important difference between a neural network and a traditional computer system is that in developing an application, a neural network is not programmed; instead, it is trained to solve a particular type of problem. This ability to learn to solve a problem makes neural networks adaptable to solving a wide variety of problems, some of which have proved intractable using a traditional computing approach. Neural networks are particularly suited to tasks involving the categorisation of patterns of information, such as is required in diagnosis and clinical decision making. In the last three years reports of applications involving neural networks have begun to appear in the medical literature, and these are described in this paper. However, a comprehensive search of the literature has shown that there have not as yet been reports of any applications in psychiatry. This paper discusses the nature of clinical decision making, outlines the sorts of problems in psychiatry which neural networks applications might be developed to address, and gives examples of candidate applications in clinical decision making.

Adult↗
PubMed1991

Hyperactivity and the fragile X syndrome.

Workers who have claimed an association between Fragile X [fra(x)] Syndrome and Hyperactivity and aggressive behavior have done so despite the lack of controlled studies using standard diagnostic criteria. Accordingly, we provided a controlled test of the hypothesis that individuals with the fra(x) Syndrome are more hyperactive and have more symptoms of aggression than other mentally retarded individuals. The test formed part of a study to assess autistic behavior in fra(x) individuals. A sample of fra(x) individuals was obtained from the register of a clinical genetics unit and individually matched for age, sex, and IQ with mentally retarded individuals selected from assessment centres. Forty-five pairs of fra(x) cases and control individuals were compared on criteria which reflected DSM-III concepts of hyperactivity and on criteria reflecting aggressive behavior. The comparison failed to find a higher prevalence of these symptoms in the fra(x) group. An analysis of the study's statistical power suggested that it is unlikely that the investigation failed to detect a large to medium difference between fra(x) individuals and control individuals in the symptoms investigated.

Adolescent↗
PubMed1990

On doing the "impossible": inferring that a putative causal relationship does not exist.

A simple heuristic is proposed for drawing a warranted inference that a causal relationship does not exist between two events. It is illustrated by a study of the putative indirect causal relationship between Autistic Disorder and the Fragile X syndrome. This study was designed to ensure that a failure to find such a relationship provided good reasons for concluding that it was unlikely there was a relationship between Autistic Disorder and the Fragile X syndrome.

Autistic Disorder↗
PubMed1989

Autism is not associated with the fragile X syndrome.

We provided a controlled test of the hypothesis that individuals with the Martin-Bell or Fragile X [fra(x)] syndrome are more autistic than mentally retarded control individuals. A sample of fra(x) individuals was obtained from the register of a clinical genetics unit and compared with mentally retarded control individuals selected from an assessment centre who were individually matched for age, sex, and IQ. A comparison of 45 pairs of fra(x) cases and control individuals on the DSM-III (R) criteria for autism and two standardized "instruments" for the assessment of autism (ABC and ADC) failed to find a higher prevalence of autism among fra(x) individuals. There was no statistically significant difference between fra(x) individuals and control individuals, and the mean differences on both the ABC and ADC scales were in the direction contrary to the hypothesis. An analysis of the study's statistical power suggested that it is unlikely the investigation failed to detect a large to medium difference between fra(x) individuals and control individuals in autistic behaviour. Subsidiary analyses of case-control differences showed that two autistic-like behaviours occurred at a higher rate among fra(x) individuals than other mentally retarded children, namely, gaze avoidance and hand flapping. These abnormalities may have misled clinicians into thinking that autism and fra(x) are associated.

Adolescent↗
PubMed1986

Isochromosome 15 with behaviour disorder.

An isochromosome of 15(q12) was found in a mentally retarded patient with behaviour disorders which included hyperactivity, short attention span, aggression, and autistic behaviour. There were only minor physical anomalies; he did not have the Prader-Willi syndrome.

Adolescent↗