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Pharmacologic therapies aid treatment for autism.

In the absence of other guidelines, practitioners often prescribe by analogy with roles of psychotropic medicines in other psychiatric disorders (e.g., the ability of serotonergic antidepressants to reduce compulsive behavior). There is a slow but steady accumulation of data supporting the use of psychotropic medications to manage certain symptoms in children with autism. These data support the use of stimulant medications for attention/hyperactivity symptoms, with willingness to suspend such treatment if a trial is unsuccessful. Risperidone is supported for other disruptive behaviors, especially of an irritable/disruptive nature, but with attention to increases in appetite and weight. SSRIs and atypical antipsychotics may be helpful for a variety of perseverative behaviors, although one would seldom prescribe antipsychotic medication for mild perseverative behavior alone. SSRIs may be useful for anxiety. Again, there is no compelling evidence that existing pharmacologic treatments have a major role in treating the core symptoms of autism, especially the profound impairments in social interaction and communication. Further well-designed double-blind studies with significant numbers of subjects and defined target symptoms will provide the data that will guide therapeutic decisions in the future.

Antipsychotic Agents↗

[Early detection and therapeutic rearing for children with mental retardation: I. Assessment of diagnosing examination and collaborative facilities assigned for children with mental retardation].

We assessed medical examinations and therapeutic rearing designed for diagnosing children with mental retardation (MR) taking three cases as an example. One hundred and seven physicians answered the questionnaire. Their tentative diagnoses were tuberous sclerosis, autistic disorder, and mental retardation, respectively. They planned medical examinations of blood cell count, urinalysis, blood biochemistry, developmental questionnaires, CT, MRI, and EEG. They chose speech and occupational therapy, nursery facilities, public health center, social welfare counselors, and parents' associations as their early intervention programs. To enrich social resources for MR children, a network of facilities and training for specialists are necessary.

Child Rearing↗

Prosopagnosia in a preschool child with Asperger syndrome.

We investigated a male, aged 4 years 11 months, who fulfilled the criteria of Asperger syndrome). In addition to the typical pattern of autistic symptoms, psychological testing revealed prosopagnosia in tasks for face recognition and matching. Prosopagnosia was also present when he tried to identify the faces of his parents and himself in photographs whenever these were presented with photographs of other persons. Although impairment in reciprocal social interaction in individuals with Asperger syndrome is closely correlated to their impaired perceptional abilities in non-verbal communication, especially facial expression, overt prosopagnosia seems to be a rare neuropsychological symptom in persons with autistic disorders.

Asperger Syndrome↗

CLINICAL PSYCHIATRY.

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Antisocial Personality Disorder↗

Augmentation of special-needs services and information to students and teachers "ASSIST"--a telehealth innovation providing school-based medical interventions.

An innovative school-based telehealth technology was introduced in Hawaii with the purposes of: (1) evaluating students for medical/developmental conditions with educational implications, (2) providing a professionally-monitored Internet-based system of learning/development, and (3) delivering medically-based physical and occupational therapy at the students school. Electronically recorded satisfaction surveys from parents, teachers, and providers revealed significant improvement in all three areas.

Attention Deficit Disorder with Hyperactivity↗

[Music therapy evaluated by schizophrenic patients].

Music therapy is presented as an integral part of the therapeutic program of an open reception ward at a state-funded psychiatric hospital. The target group for music therapy comprises schizophrenic patients whose primary psychopathological symptoms are characterized by basic disorders, autistic withdrawal, anergia and limited means of verbal communication. A sample of 30 schizophrenic patients selected for music therapy is described. The subjective evaluation and rating of the music therapy was registered using a specially developed questionnaire. The primary results are: 1. Music therapy has a high level of subjective acceptance among patients. 2. No negative effects are recorded despite the therapy being introduced in the post-acute phase. 3. The positive therapeutic effects quoted are relaxation, activation, reduced anxiety, easier contact-making, and improved opportunities for emotional expression. The duration of the effects is limited. 4. The training-related concept and the clearly structuring behavior of the group leader are given a positive rating by the patients.

Adult↗

Schizophrenia and brain asymmetry an evaluation of evidence for dominant lobe dysfunction.

The author reviewed literature implicating a disturbance located in the left cerebral hemisphere in the pathogenesis of schizophrenia. Studies of the psychiatric sequelae of lateralized organic cerebral disease were considered, as well as neurological, neurophysiological, and neuroanatomic studies of psychiatric patients. In general, abnormalities in cerebral hemispheric asymmetry appear to be common among psychiatric patients, particularly those with personality disorders, some affective disorders, autistic children, and, at least, some schizophrenics. The latter may include those with milder, less chronic illnesses. A specific relationship between the side of unilateral cerebral impairment and diagnosis suggested by some authors is not consistently supported by the literature, however. The implications of these findings are discussed in terms of neurodevelopmental issues in schizophrenia.

Brain Diseases↗