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Results for “Child Development Disorders, Pervasive”

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PubMed1993

Developmental aspects of attachment behavior in young children with pervasive developmental disorders.

OBJECTIVE: The present study applied a continuous, clinically based rating system to compare predictions about attachment behavior in autism resulting from three different theoretical views and to characterize differences in attachment behavior of young autistic children. METHOD: The attachment behaviors of 32 young children with autism or pervasive developmental disorder were examined in a modified "strange situation." Attachment behaviors were rated on a continuous scale and on the Ainsworth subscales. Attachment ratings were compared with several developmental variables, including chronological age, mental age, language level, and social level. RESULTS: The continuous rating scale distinguished signs of security from signs of insecurity, allowing for behavioral idiosyncracies in the expression of attachment behavior seen in autistic children. The study found that 50% of the children demonstrated some behaviors indicative of secure attachment, that no children were unattached, and that developmental level rather than severity of autism was the strongest predictor of attachment security. CONCLUSIONS: Autism does not preclude the development of secure attachment relationships in young children, but rather it delays the development of secure attachment and may alter the behavioral patterns that express attachment security.

Autistic Disorder↗
PubMed1995

An outpatient treatment program for young children with pervasive developmental disorder.

Clinical experiences with some fourteen young children (under 3 1/2 years) suffering from pervasive developmental disorder led to the design of an outpatient treatment program. The conceptual basis for the program was facilitated by two important changes in theory. The first was a shift in our understanding of infancy, based on observations rather than reconstruction from adult and child analysis; the second was the gradual evolvement in our understanding of this disorder. The treatment program has three components: (1) a prolonged period of parent-child or adult-child interactions aimed at attracting the attention of the child and helping him or her develop imitations, interaction, and communication; (2) intense instruction, with the help of an occupational therapist, designed to teach the child basic life skills such as eating, dressing and undressing, and toilet training; and (3) exposure to normal social interactions with other children within a day-care or preschool facility to encourage joining in the usual childhood activities. The success of the program depends heavily on coordination among all the people involved: ideally they should include the parents, speech therapist, occupational therapist, teachers, child-care worker, and clinician.

Activities of Daily Living↗
PubMed2005

Clinical significance of tics and attention-deficit hyperactivity disorder (ADHD) in children with pervasive developmental disorder.

The goal of this study was to examine the clinical significance of co-occurring tics and attention-deficit hyperactivity disorder (ADHD) as indicators of a more complex symptomatology in children with and without pervasive developmental disorder. Parents and teachers completed a Diagnostic and Statistical Manual of Mental Disorders-IV-referenced rating scale for 3- to 5- (n = 182/135) and 6- to 12- (n = 301/191) year-old children with pervasive developmental disorder and clinic controls, respectively. The percentage of children with tic behaviors varied with age: preschoolers (25%, 44%) versus elementary schoolchildren (60%, 66%) (parent and teacher ratings, respectively). For many psychiatric symptoms, screening prevalence rates were highest for the ADHD + tics group and lowest for the group with symptoms of neither, but the pattern of group differences varied by age group and informant. In general, there were few differences between the ADHD only and tics only groups. The pattern of ADHD/tic group differences was similar for both children with and without pervasive developmental disorder. We concluded that these findings support the notion that the co-occurrence of ADHD and tics is an indicator of a more complex psychiatric symptomatology in children with pervasive developmental disorder.

Attention Deficit Disorder with Hyperactivity↗
PubMed1993

Assessing the relationship between affective responsivity and social interaction in children with pervasive developmental disorder.

An investigation of children with pervasive developmental disorder (PDD) was conducted using a new instrument, the Kiddie-Infant Descriptive Instrument for Emotional States (KIDIES). The KIDIES rates several affective and behavioral dimensions based on facial, vocal, gestural, and postural cues. The study's goals were to determine whether the KIDIES could detect individual differences in responsivity among the PDD subjects; to ascertain the KIDIES' sensitivity in identifying group differences between PDD subjects and control children with other developmental disorders. Children were videotaped during episodes with three partners: the mother, a familiar female teacher, an unfamiliar male doctor. Episodes were scored using the KIDIES. PDD subjects were most severely impaired during the Mother episode in comparison to the controls. Equally as striking was the within-episode heterogeneity among PDD subjects. During the Teacher episode, PDD subjects were twice as variable in interpersonal response as the controls.

Affective Symptoms↗
PubMed1991

Reliability of clinical ratings by trainee child psychiatrists: a research note.

Trainee and senior psychiatrists separately rated the symptoms and signs of 14 consecutive referrals to a child psychiatric team. Inter-rater reliabilities ranged from 0.61 to 0.94 on four clinically relevant dimensions of psychopathology. Aggregating all items, trainees' ratings identified whether or not items were definitely present with greater than 95% accuracy, as judged by a senior psychiatrist's ratings and a review of the case notes. This pilot study suggests that trainees' ratings can be of acceptable reliability for research purposes.

Affective Symptoms↗
PubMedDate not supplied

Assessment of children with pervasive developmental disorders.

TOPIC: Pervasive developmental disorders, a group of conditions marked by impaired social reciprocity, communication deficits, and restricted, repetitive behaviors. PURPOSE: Advanced practice nurses (APNs) are in a unique position to assess these children, make appropriate diagnoses, and refer parents for further consultation and intervention. SOURCES: Current literature, formal training on diagnostic instruments, and clinical experience. CONCLUSIONS: Diagnosis of pervasive developmental disorders requires knowledge of normal growth and development and other childhood psychiatric disorders. The role of the APN includes counseling parents regarding their child's legal right to intervention and guiding parents to make empirically based choices for intervention.

Asperger Syndrome↗
PubMed2004

The predictive value of a preschool diagnosis of developmental language impairment.

OBJECTIVE: To evaluate language and cognitive outcomes in elementary school children with a prior preschool diagnosis of developmental language impairment (DLI). DESIGN/METHODS: A cohort of preschool children, consecutively diagnosed with isolated language impairment, was reassessed in elementary school. Measures used were the communication domains of the Battelle Developmental Inventory (BDI) and the Vineland Adaptive Behavior Scale, Peabody Picture Vocabulary and Expressive One Word Picture Vocabulary. Cognition was assessed using the BDI cognitive domain. Language impairment was defined as performance more than 1.25 SD below normative means on a language measure. Specific language impairment (SLI) was defined as language impairment concurrent with a cognitive score not more than one SD below the normative mean. RESULTS: A total of 43/70 (61%) children were reassessed. Mean age in preschool was 3.6 +/- 0.7 years and 7.4 +/- 0.7 years at follow up. A total of 36/43 (84%) showed persistent language impairment. The mean BDI cognitive domain score was 80.0 +/- 14.2 (15/42 below -2 SDs). Only 11/42 (26%) children met current research criteria for SLI, 24/42 (57%) had language impairment but had cognitive scores more than one SD below normative means, and 4/42 (10%) had normal language and cognitive skills. No factors could be identified at intake that predicted language outcome using univariate or multivariate analysis. CONCLUSIONS: While a preschool diagnosis of developmental language impairment predicted persisting language impairment, the specificity of this impairment did not persist. This suggests either undiagnosed cognitive impairment in preschool children with apparently isolated language impairment or an evolving profile of more global developmental impairment.

Age Factors↗
PubMed2002

Increased prevalence of pervasive developmental disorders in children with slight arylsulfatase A deficiency.

Arylsulfatase A deficiency (less than 15% of controls) is responsible for a neurological disorder known as metachromatic leukodystrophy. Nonetheless, low levels of the enzyme (15-50% of controls, higher than in metachromatic leukodystrophy) in adult patients have been related to neuropsychiatric disorders. On the other hand, there are only few and controversial data on the significance of reduced arylsulfatase A activity in children. This led us to perform the present study. Various classes of arylsulfatase A activity in children have been related with different groups of neuropsychiatric disorders and compared with a similar number of healthy children. We found a high percentage of reduced arylsulfatase A (less than 50% of controls) in children with pervasive developmental disorders (10.25%). Unexpectedly, raising the threshold level for considering arylsulfatase A deficiency up to 70% of controls resulted in a marked increase in the incidence of pervasive developmental disorders. This new class, arylsulfatase A slight deficiency, contained the highest number of patients affected by psychiatric symptoms. This suggests that arylsulfatase A slight deficiency could be a marker of a subclass of pervasive developmental disorders.

Adolescent↗
PubMed2004

'Nurturing the brain' as an emerging research field involving child neurology.

'Nurturing the brain' is an emerging research field integrating brain science, child care and education, which also involves child neurology. It has emerged from the recent remarkable progress in brain science and strong social demands for improvements in child care and education. This article reviews the current status of three major research themes in this field. First, developmental disorders represented by attention deficit/hyperactivity disorder, autism and Asperger syndrome often introduce difficulties in child care and education, which are to be addressed by appropriate assessment and treatment of affected children based on new knowledge of the pathogenesis of these disorders. Second, recent progress in research on the critical/sensitive periods of development of brain structures and functions promises useful advice for teachers and parents regarding optimal timing and ways of teaching various subjects. Third, the development of the brain throughout infancy, childhood and adolescence is paralleled by the growth and maturation of the mind. Neuronal mechanisms underlying the theory of mind, mirror neurons, internal model, cognitive control, and cognitive emotion regulation are important themes that bridge our understandings of the brain and the mind.

Attention Deficit Disorder with Hyperactivity↗
PubMed2004

Developmental, behavioural and somatic factors in pervasive developmental disorders: preliminary analysis.

OBJECTIVES: To ascertain the frequency of parental reporting of selected variables related to development, behaviour and physiology in subgroups diagnosed with pervasive developmental disorders (PDDs) and identify any significant intragroup differences. DESIGN: Retrospective cross-sectional analysis of records of patients (n = 512) held on a computerized database with a chronological age between 3 and 11 years resident in the UK/Republic of Ireland and with a formal diagnosis of autism, Asperger syndrome (AS) or autism spectrum disorder (ASD). METHODS: Non-parametric analysis (P > 0.01) of the frequency of specific variables for PDD subgroups reported by parents/primary caregiver. VARIABLES INCLUDED: timing of symptom onset, presence of skills acquired prior to symptom onset, indications of regression and regression events, current language, history of viral infections, history of ear problems, achievement of continence, current skin complaints, current bowel habits and adverse events at parturition. RESULTS: Preliminary results showed general agreement with the principle diagnostic differences between the PDD subgroups with patients diagnosed with AS showing an increased frequency of skills acquired before symptom onset (two- to three-word phrase speech, toileting skills) and a decreased frequency of regression in acquired skills when compared with other PDD subgroups. Developmental milestones such as the achievement of bowel and bladder continence were also more frequently reported for the AS group. Infantile feeding problems defined as vomiting, reflux, colic and failure to feed were more frequently reported for the AS group as was a reported history of the bacterial skin infection impetigo. Results are discussed with reference to relationships between behavioural and somatic factors in PDD.

Asperger Syndrome↗
PubMed1990

DSM-III and DSM-III-R diagnosis of autism and pervasive developmental disorder in nursery school children.

DSM-III and DSM-III-R diagnoses of 112 developmentally disordered preschool children were compared. There was no significant difference between the DSM-III and DSM-III-R diagnosis of the inclusive category of pervasive developmental disorder, but nearly twice as many cases (58) were diagnosed as autistic disorder by DSM-III-R criteria as were diagnosed as infantile autism (31) by DSM-III. Thirty children met both DSM-III and DSM-III-R criteria for autism (IA/AD) and 23 received a DSM-III diagnosis of atypical PDD (A-PDD) and a DSM-III-R diagnosis of AD (A-PDD/AD). All of the IA/AD children and none of the A-PDD/AD group displayed a marked lack of awareness of others. DSM-III-R criteria have specifically broadened the concept of autism to include children who, although socially impaired, are not pervasively unresponsive to others.

Autistic Disorder↗