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Interrelationship between Autism Diagnostic Observation Schedule-Generic (ADOS-G), Autism Diagnostic Interview-Revised (ADI-R), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) classification in children and adolescents with mental retardation.

The interrelationship between the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule-Generic (ADOS-G) and clinical classification was studied in 184 children and adolescents with Mental Retardation (MR). The agreement between the ADI-R and ADOS-G was fair, with a substantial difference between younger and older children (5-8 vs. 8+ years). Compared with the Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM-IV-TR) classification of Autistic Disorder (AD) and Pervasive Developmental Disorder (PDD), both instruments measure AD or PDD validly and reliably. Even in low-functioning children the interrelationship between the instruments and the clinical classification was satisfactory. The combination of ADI-R and ADOS-G identifies AD or PDD, as described in the DSM-IV-TR, most appropriately. Both instruments seem to be of great value in the diagnostic process of PDD in children and adolescents with MR.

Adolescent↗

Epidemiology of autism in Singapore: findings of the first autism survey.

The report describes the results of a survey conducted on 176 parents of children with autism in Singapore. The ages of the children ranged from 3 to 12 years. The survey focused on the child's background, behaviour problems and skill profile, the home and school situation as well as the linguistic and social background. It was noted that the Singapore population confirms the international distribution regarding a predominance of boys over girls and a low incidence of birth complications. A positive trend noted was the fact that 60% of the children were diagnosed before the age of 3 years. Discussion focuses on possible risk factors and psychosocial adversities for autism such as a high frequency of caregivers who are foreign maids, the use of multiple languages and the high level of punitive educational practices. The possible influence of psychosocial deprivation on child development is discussed.

Autistic Disorder↗

The standardized diagnosis of autism, Autism Diagnostic Interview-Revised: interrater reliability of the German form of the interview.

The feasibility and reliability of the German form of the revised parental interview to diagnose autism (Autism Diagnostic Interview-Revised, ADI-R) was investigated in this study. Brief examples of the description of formerly and currently used diagnostic guidelines are given and the outline of the interview algorithm which establishes thresholds for inclusion criteria. An excellent-to-good reliability could be demonstrated for the main symptoms according to the classification rules of the ICD-10 and DSM-IV for a sample of autistic subjects at different ages and intellectual levels. The results approve the use of this interview for research and clinical purposes.

Adolescent↗

How well does early diagnosis of autism stand the test of time? Follow-up study of children assessed for autism at age 2 and development of an early diagnostic service.

Twenty children who presented with severe and communication difficulties at age 2 underwent a comprehensive assessment for autism, and were reassessed at age 4-5. In common with other recent studies, diagnosis of autistic spectrum disorders at age 2 was found to be reliable and stable. The communication and social skills of the children showed little change overall by the second assessment. However, children whose scores deteriorated in the social domain tended to have presented initially with more significant behaviour problems. Few repetitive behaviours were observed at age 2, whereas these were more apparent by age 4-5. The finding that early diagnosis of autism is reliable and stable has led to the development of an early diagnostic service in Southampton, which is described. The importance of early diagnosis is that it opens the door to early intervention programmes, which in turn prevent many problems from occurring in later life.

Age of Onset↗

The immune response in autism: a new frontier for autism research.

Autism spectrum disorders (ASD) are part of a broad spectrum of neurodevelopmental disorders known as pervasive developmental disorders, which occur in childhood. They are characterized by impairments in social interaction, verbal and nonverbal communication and the presence of restricted and repetitive stereotyped behaviors. At the present time, the etiology of ASD is largely unknown, but genetic, environmental, immunological, and neurological factors are thought to play a role in the development of ASD. Recently, increasing research has focused on the connections between the immune system and the nervous system, including its possible role in the development of ASD. These neuroimmune interactions begin early during embryogenesis and persist throughout an individual's lifetime, with successful neurodevelopment contingent upon a normal balanced immune response. Immune aberrations consistent with a dysregulated immune response, which so far, have been reported in autistic children, include abnormal or skewed T helper cell type 1 (T(H)1)/T(H)2 cytokine profiles, decreased lymphocyte numbers, decreased T cell mitogen response, and the imbalance of serum immunoglobulin levels. In addition, autism has been linked with autoimmunity and an association with immune-based genes including human leukocyte antigen (HLA)-DRB1 and complement C4 alleles described. There is potential that such aberrant immune activity during vulnerable and critical periods of neurodevelopment could participate in the generation of neurological dysfunction characteristic of ASD. This review will examine the status of the research linking the immune response with ASD.

Animals↗

Prevalence of autism in Missouri: changing trends and the effect of a comprehensive state autism project.

To assess change in autism prevalence in Missouri from 1988 until 1995, computerized client registries from the Regional Diagnostic Centers were analyzed. In the five to nine year age group, the prevalence rose thirty fold from 0.15 to 4.8 per 10,000. The study period coincides with the establishment of the Missouri Autism Project suggesting that provision of services will increase the apparent prevalence figures and that autistic disorders were previously underdiagnosed in Missouri.

Adolescent↗

[Syndromic autism: II. Genetic syndromes associated with autism].

INTRODUCTION AND DEVELOPMENT: In this study we report on the different genetic syndromes in which autism has been described as one of the possible manifestations. CONCLUSIONS: Certain genetic syndromes are providing us with extremely valuable information about the role played by genetics in autism. This is the case of the following syndromes: Angelman syndrome, Prader-Willi syndrome, 15q11-q13 duplication, fragile X syndrome, fragile X premutation, deletion of chromosome 2q, XYY syndrome, Smith-Lemli-Opitz syndrome, Apert syndrome, mutations in the ARX gene, De Lange syndrome, Smith-Magenis syndrome, Williams syndrome, Rett syndrome, Noonan syndrome, Down syndrome, velo-cardio-facial syndrome, myotonic dystrophy, Steinert disease, tuberous sclerosis, Duchenne's disease, Timothy syndrome, 10p terminal deletion, Cowden syndrome, 45,X/46,XY mosaicism, Myhre syndrome, Sotos syndrome, Cohen syndrome, Goldenhar syndrome, Joubert syndrome, Lujan-Fryns syndrome, Moebius syndrome, hypomelanosis of Ito, neurofibromatosis type 1, CHARGE syndrome and HEADD syndrome.

Autistic Disorder↗

Brief report: "the autism epidemic". The registered prevalence of autism in a Swedish urban area.

The objective of this study was to establish rates of diagnosed autism spectrum disorders (ASDs) in a circumscribed geographical region. The total population born in 1977-1994, living in Göteborg Sweden in 2001, was screened for ASD in registers of the Child Neuropsychiatry Clinic. The minimum registered rate of autistic disorder was 20.5 in 10,000. Other ASDs were 32.9 in 10,000, including 9.2 in 10,000 with Asperger syndrome. Males predominated. In the youngest group (7-12 years), 1.23% had a registered diagnosis of ASD. There was an increase in the rate of diagnosed registered ASD over time; the cause was not determined. The increase tended to level off in the younger age cohort, perhaps due to Asperger syndrome cases missed in screening.

Asperger Syndrome↗

Long-term memory in high-functioning autism: controversy on episodic memory in autism reconsidered.

Two studies were conducted to examine the nature of verbal long-term memory (LTM) in people with autism. In Study 1, undergraduate students showed better LTM and more verbal associations for concrete than abstract nouns. Probability of recall of the nouns strongly correlated with the number of associations with those nouns. In Study 2, unlike controls, autistic subjects did not show superior recall of concrete over abstract nouns despite overall comparable performance. A highly significant correlation between probability of recall and associative value was found only in the controls. Furthermore, there was an unusual correlation between LTM performance and a nonverbal measure in the autistic group. The results were discussed in terms of the relation between episodic memory and semantic memory.

Adolescent↗

A "new" chromosome marker common to the Rett syndrome and infantile autism? The frequency of fragile sites at X p22 in 81 children with infantile autism, childhood psychosis and the Rett syndrome.

Chromosomes from 46 autistic, 20 psychotic and 15 Rett syndrome children were cultured in a folic-acid-depleted medium. Nine percent of the autistic, 20% of the psychotic and 40% of the Rett syndrome cases showed a "new" chromosomal anomaly, viz a fragile site at the (X) (p22) location. It is suggested that in some cases of autism/psychosis and the Rett syndrome, there might be a common biological marker for the common type of psychiatric disturbance. However, as the population frequency of the chromosome marker is not yet known, conclusions must be drawn with great caution.

Adolescent↗