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PubMed1996

Clinical studies of pervasive developmental disorders in Japan.

Articles on pervasive developmental disorders (PDD) published mainly by Japanese child psychiatrists in international journals for the last 20 years were reviewed for the purpose of clarifying the accomplishment and aims of Japanese PDD research. Although Japanese child psychiatrists investigated PDD in various specialties, their contributions to international archives were much fewer than those of Japanese professionals in other branches of medical sciences. This may be accounted for by the absence of an authorized education system of child psychiatrists and strong clinical orientation together with some reluctance of Japanese child psychiatrists to perform research. However, the epidemiology of PDD subtypes, the speech loss in PDD and the psychopathology of persons with high-functioning PDD seem to be providing promising research areas for Japanese child psychiatrists based on their clinical experiences.

Autistic Disorder↗

PubMed1987

CSF monoamines in autistic syndromes and other pervasive developmental disorders of early childhood.

Spinal fluid concentrations of the three major monoamine metabolites were examined in 25 infantile autistic children and 12 children with other childhood psychoses, and were contrasted with results obtained in normal children and in groups of children with neurological and neurodevelopmental disorders. Autistic children showed absolute and relative increases of the dopamine metabolite homovanillic acid. The group with other childhood psychoses also showed an increase in HVA level; in this group there were also indications of high levels of serotonin and norepinephrine metabolites. The results are discussed in the context of a pathogenetic model for autism involving hyperfunction of dopaminergic nerve fibres in the brain stem-mesolimbic system.

Adolescent↗

PubMed2006

The economic burden of pervasive developmental disorders in a privately insured population.

The objective of this study was to compare health care costs and utilization in children with pervasive developmental disorders (PDDs), asthma, or diabetes. Data for this investigation were derived from a large U.S. commercial insurance plan. Total cost per child and number of outpatient claims were significantly higher six months prediagnosis and 12 months postdiagnosis for PDD (N = 470) than for asthma (N = 550) or diabetes (N = 475). Controlling for age, gender, insurance plan, and prediagnosis costs, total cost per child during the postdiagnosis period was higher for PDD than for asthma or diabetes. Privately insured children with a PDD incur significantly greater costs and utilization and significantly more outpatient services than privately insured children with diabetes or asthma.

Adolescent↗

PubMed1987

Characteristics of preschool children diagnosed as having an atypical pervasive developmental disorder.

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.

Affect↗

PubMed2007

Abnormalities on the neurological examination and EEG in young children with pervasive developmental disorders.

This study examined the nature and frequency of neurological and EEG abnormalities in 60 young children (ages 2-6 years) with pervasive developmental disorders. A number of standard neurological functions could not be adequately assessed due to the young age of the children and/or limited comprehension and cooperation. The most common neurological deficits were hyporeflexia, stereotypies, and hypotonia. EEG abnormalities were identified in 32% of the children while only two children were known to have clinical seizures. The frequency of cases with hypotonia or hyporeflexia was more common than in older children with this diagnosis. Results also indicate that EEG abnormalities are common in this young population but clinical seizures are rare, confirming other studies.

Autistic Disorder↗

PubMed1997

Beta-endorphin and cholecystokinin 8 concentrations in peripheral blood mononuclear cells of autistic children.

beta-Endorphin (beta-EP) and cholecystokinin 8 (CCK-8) concentrations in peripheral blood mononuclear cells were measured in 12 drug-free autistic (AU) children, in 10 drug-free children with pervasive developmental disorders (PDD) and in 11 healthy controls. The aim of the study was to see whether or not there was an alteration of beta-EP and CCK-8 concentrations in this peripheral compartment, in which it has been suggested that secretion and regulation of the two peptides mimic those of neurons in the central nervous system. Mean beta-EP values were significantly higher in AU than in PDD and control children, while there were no differences in CCK-8 values of the three groups.

Adolescent↗

PubMed2002

A descriptive study of hyperlexia in a clinically referred sample of children with developmental delays.

In this study, we evaluated the incidence of hyperlexia in a clinically referred sample of 80 children with developmental delays. Based on hypotheses previously formulated in the literature, the study investigated the frequency of hyperlexia among boys and girls, the incidence of hyperlexia in children with Pervasive Developmental Disorders (PDD)-spectrum compared with non-PDD diagnoses, the range of IQ and of various cognitive skills in children with and without hyperlexia, and the developmental outcomes of children with and without hyperlexia. The results revealed no significant differences in the frequency of hyperlexia in girls compared with boys. However, the frequency of hyperlexia was significantly elevated among children with PDD compared with children with non-PDD diagnoses. The range of IQ and other cognitive skills and the developmental outcomes of children with hyperlexia were comparable to those of children without hyperlexia.

Child↗

PubMedDate not supplied

Relation of the childhood autism rating scale-parent version to diagnosis, stress, and age.

This study explored the relation of severity of functional impairment on the Childhood Autism Rating Scale-Parent version (CARS-P) to diagnosis, parenting stress, and child age. Twenty-two mothers of children with autism and 19 mothers of children with pervasive developmental disorder-not otherwise specified (PDD-NOS) completed the CARS-P and the Parenting Stress Index. The autism group received significantly higher (i.e., more severe impairment) CARS-P ratings that did the PDD-NOS group. For the total sample, severity of impairment was a significant predictor of child-related parenting stress. The CARS-P was inconsistently associated with age-significantly positive for the PDD-NOS group but nonsignificantly for the autism group. Implications for the use of the CARS-P in assessment of children and the evaluation of interventions are discussed.

Activities of Daily Living↗

PubMed2004

Body mass index of children from the United Kingdom diagnosed with pervasive developmental disorders.

BACKGROUND: The aim of the present study was to ascertain the Body Mass Index (BMI) (kg m(-2)) derived from parental reports of height (metres) and weight (kilograms) of a pilot sample of boys born and resident in the UK diagnosed with pervasive developmental disorders (PDD). METHOD: Analysis of parental reporting of height and weight measurements in boys (n=50) diagnosed with PDD and comparison with age and sex-matched reference populations. RESULTS: The majority of patients were above the 50th percentile for height (70%), weight (74%) and BMI (80%) with 21% exceeding cut-off points for overweight and 10% for clinical obesity. There were no significant differences (P < 0.05) found between PDD subgroups for any of the measures. CONCLUSION: Further studies are required to validate findings of skewed height, weight and BMI data in PDD.

Body Height↗

PubMed1999

Magnetoencephalographic patterns of epileptiform activity in children with regressive autism spectrum disorders.

BACKGROUND: One-third of children diagnosed with autism spectrum disorders (ASDs) are reported to have had normal early development followed by an autistic regression between the ages of 2 and 3 years. This clinical profile partly parallels that seen in Landau-Kleffner syndrome (LKS), an acquired language disorder (aphasia) believed to be caused by epileptiform activity. Given the additional observation that one-third of autistic children experience one or more seizures by adolescence, epileptiform activity may play a causal role in some cases of autism. OBJECTIVE: To compare and contrast patterns of epileptiform activity in children with autistic regressions versus classic LKS to determine if there is neurobiological overlap between these conditions. It was hypothesized that many children with regressive ASDs would show epileptiform activity in a multifocal pattern that includes the same brain regions implicated in LKS. DESIGN: Magnetoencephalography (MEG), a noninvasive method for identifying zones of abnormal brain electrophysiology, was used to evaluate patterns of epileptiform activity during stage III sleep in 6 children with classic LKS and 50 children with regressive ASDs with onset between 20 and 36 months of age (16 with autism and 34 with pervasive developmental disorder-not otherwise specified). Whereas 5 of the 6 children with LKS had been previously diagnosed with complex-partial seizures, a clinical seizure disorder had been diagnosed for only 15 of the 50 ASD children. However, all the children in this study had been reported to occasionally demonstrate unusual behaviors (eg, rapid blinking, holding of the hands to the ears, unprovoked crying episodes, and/or brief staring spells) which, if exhibited by a normal child, might be interpreted as indicative of a subclinical epileptiform condition. MEG data were compared with simultaneously recorded electroencephalography (EEG) data, and with data from previous 1-hour and/or 24-hour clinical EEG, when available. Multiple-dipole, spatiotemporal modeling was used to identify sites of origin and propagation for epileptiform transients. RESULTS: The MEG of all children with LKS showed primary or secondary epileptiform involvement of the left intra/perisylvian region, with all but 1 child showing additional involvement of the right sylvian region. In all cases of LKS, independent epileptiform activity beyond the sylvian region was absent, although propagation of activity to frontal or parietal regions was seen occasionally. MEG identified epileptiform activity in 41 of the 50 (82%) children with ASDs. In contrast, simultaneous EEG revealed epileptiform activity in only 68%. When epileptiform activity was present in the ASDs, the same intra/perisylvian regions seen to be epileptiform in LKS were active in 85% of the cases. Whereas primary activity outside of the sylvian regions was not seen for any of the children with LKS, 75% of the ASD children with epileptiform activity demonstrated additional nonsylvian zones of independent epileptiform activity. Despite the multifocal nature of the epileptiform activity in the ASDs, neurosurgical intervention aimed at control has lead to a reduction of autistic features and improvement in language skills in 12 of 18 cases. CONCLUSIONS: This study demonstrates that there is a subset of children with ASDs who demonstrate clinically relevant epileptiform activity during slow-wave sleep, and that this activity may be present even in the absence of a clinical seizure disorder. MEG showed significantly greater sensitivity to this epileptiform activity than simultaneous EEG, 1-hour clinical EEG, and 24-hour clinical EEG. The multifocal epileptiform pattern identified by MEG in the ASDs typically includes the same perisylvian brain regions identified as abnormal in LKS. When epileptiform activity is present in the ASDs, therapeutic strategies (antiepileptic drugs, steroids, and even neurosurgery) aimed at its control can lead to a significa

Autistic Disorder↗

PubMed1996

[Pervasive developmental disorders: neurological perspectives].

The pervasive disorders of development (TPD) or disorders within the spectrum of autism (TEA) are two terms which are often used to describe a well-defined group of behaviour disorders characterized by changes in social interaction and language communication together with repetitive behaviour patterns. This group of disorders has multiple etiologies and the clinical manifestations vary in severity. In this study the incidence of a selected group of neurological changes and neurodiagnostic tests in 421 children with TDP is analyzed. 11% of the children had genetic disorders such as chromosomial disorders, genetic syndromes and family incidence. 18% of the children had motor disorders with hypotonicity being the commonest (85%). 71% of the children were stereotyped. 59% of the children had cogniscitive functions which were appropriate, or nearly so, for their chronological age, 28% of the children had language regression. 13% had epileptic crises. The electroencephalogram and cerebral magnetic resonance were abnormal in 29% and 19% respectively of the children on whom these tests were done.

Brain↗

PubMed1984

Auditory brainstem responses in pervasive developmental disorders.

Several studies have reported prolonged neural transmission times on auditory brainstem responses (ABRs) measured in autistic children, a finding which implicates CNS dysfunction at the level of the brainstem in autistic conditions. This study measured ABRs in 25 children and adults with pervasive developmental disorders (PDDs), including autism, and 25 age- and sex-matched normal controls. Subjects were carefully evaluated audiometrically and neurologically and artifact was controlled to produce highly reliable measures. Prolonged transmission times were seen in only one PDD subject and in one normal control, while shortened transmission times were seen in four PDD subjects. The majority of PDD subjects showed normal ABRs. Previous reports of a significant incidence of prolonged transmission times among autistic and autisticlike subjects, thus, were not replicated. Possible reasons for this discrepancy are discussed.

Adolescent↗

PubMed1991

Tourette syndrome and autistic disorder: a significant relationship.

The histories of 10 children with autistic disorder or pervasive developmental disorder (PDD) cooccurring with familial Tourette syndrome (TS) are presented. Evidence from the histories of the patients and their relatives combined with other reports of cases of cooccurrence of TS and autism provides support for the hypothesis that TS may be responsible for cases of coocurrence of the disorders, contributes significantly to the etiological heterogeneity of autistic disorder and that a portion of cases of autism may actually be a result of homozygosity for the TS gene. In addition, the presence of affective disorders and autistic-like syndromes or mild disturbances of social relatedness in some of the pedigrees suggests the hypothesis that TS may be responsible for a subgroup of families with cooccurring affective and autistic disorders and for some cases of familial aggregation of autism-PDD.

Adult↗

PubMed1995

Empirically derived subtypes of pervasive developmental disorders: a cluster analytic study.

A cluster analytic study was conducted to empirically derive behaviorally homogeneous subtypes of pervasive developmental disorders (PDD). Subjects were clustered based on a broad range of behavioral symptoms which characterize autism. Behavioral variables were measured using several of the standardized psychometric instruments most commonly employed in assessing autistic individuals. The cluster solution indicated the presence of four distinct groups. Validity checks generally confirmed significant between-group differences on independent measures of social, language, and stereotyped behaviors. In addition, the four-group cluster solution was compared to previously developed typological systems of PDD (i.e., subcategories based on IQ early onset, styles of social interaction, and DSM-III-R diagnosis). Results generally supported both the behavioral homogeneity of the four subgroups and also several important between-group differences. The potential utility of using cluster analyses to explore subtypes of PDD is discussed.

Adolescent↗

PubMed2005

Relationship-focused early intervention with children with pervasive developmental disorders and other disabilities: a comparative study.

This study compares the effects of relationship-focused early intervention on toddlers and preschool-age children who were classified as having either pervasive developmental disorders (PDDs) (N = 20) or developmental disabilities (DDs) (N = 30). The intervention was conducted over a 1-year period through weekly individual parent-child sessions. It focused on helping parents use responsive teaching strategies to encourage their children to acquire and use pivotal developmental behaviors that addressed their individualized developmental needs. Before and after comparisons indicated significant increases in parents' responsiveness and children's pivotal behavior. Both groups of children made significant improvements in their cognitive, communication, and socioemotional functioning. However, children with PDDs made statistically greater improvements on the developmental measures than children with DDs. On several developmental measures, children's improvements were related to increases in both their parents' responsiveness and their own pivotal behavior.

Adult↗

PubMed2000

High functioning autism and Childhood Disintegrative Disorder in half brothers.

Childhood Disintegrative Disorder (CDD) is grouped with autism as a subtype of Pervasive Developmental Disorder (PDD) in ICD-10 and DSM-IV. This is the first report of autism and CDD cosegregating within a sibship. J. P. and M. P. are half-brothers with the same mother. J. P. is an 18-year-old with impairments in communication, social reciprocity, and stereotypies and was diagnosed with autism. M. P. is a 7-year-old who developed normally to 2 years 4 months. He then underwent a profound regression, becoming nonverbal and socially withdrawn, and lost adaptive skills. Investigations did not reveal any neurodegenerative process. M. P. was diagnosed with CDD. The rarity of the two conditions suggests a shared transmissible mechanism. The implications for autism/PDD genetic studies are discussed.

Adolescent↗

PubMed2001

The phenotypic manifestations of interstitial duplications of proximal 15q with special reference to the autistic spectrum disorders.

This study investigated the phenotypic manifestations of interstitial duplications of chromosome 15 that involve the Prader-Willi/Angelman syndrome critical region (PWACR). Twenty-one affected individuals from six families were evaluated in detail, using standardized and semi-standardized measures of intelligence, psychopathology, and physical anomalies. Special attention was placed on determining the prevalence of autism spectrum disorders as well as the relationship between the parental origin of the duplication and the phenotypic effects. Assessments of the affected individuals were compared with evaluations of the unaffected relatives from the same families. Results indicated that duplications in the region were associated with variable degrees of intellectual impairments and motor coordination problems. Four of the subjects received a diagnosis of pervasive developmental disorder. Three of these cases were probands and only one met criteria for classic autism. There was very little evidence of the duplication cosegregating with autism spectrum disorder diagnosis. Paternally inherited duplications were significantly less likely to give rise to phenotypic effects. The findings indicate that duplications in the PWACR give rise to developmental delay but not necessarily autism spectrum disorders. They also suggest that phenotypic expression is dependent on the parental origin of the duplication and implicate maternally active genes in the pathogenesis of the developmental impairments. Further research will be required to clarify the range and basis of the phenotypic manifestations.

Adult↗

PubMed2005

Epidemiology of autistic disorder and other pervasive developmental disorders.

Is the incidence of autistic disorder and other pervasive developmental disorders (PDDs) increasing? Recent epidemiological surveys of autistic disorder and other PDDs have heightened awareness of and concern about the prevalence of these disorders; however, differences in survey methodology, particularly changes in case definition and case identification over time, have made comparisons between surveys difficult to perform and interpret. Recent surveys suggest that the rate of all PDDs is about 60 per 10,000. The prevalence of autism today is estimated at 13 per 10,000, Asperger's disorder is approximately 3 per 10,000, and childhood disintegrative disorder is very rare at about 0.2 per 10,000. The assessment process, sample size, publication year, and geographic location of studies all have an effect on prevalence estimates. In addition, data from many of these surveys indicate correlates of autistic disorder and other PDDs with IQ, gender, and other medical disorders.

Adolescent↗