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[A comparative study of pragmatic language disorders and autism spectrum disorders using magnetoencephalography].

INTRODUCTION: Pragmatics refers to the social use of language; its precursors are already present during the process of maturing, during the preverbal stage, and become manifest when the child starts to point and to share his or her attention with another person. In cases of specific language impairment (SLI) and autism spectrum disorders (ASD) it can be altered to varying degrees. PATIENTS AND METHODS: Due to the difficulties involved in diagnosis from a clinical point of view, we carried out a study by means of magnetoencephalography (MEG) on a series of 11 patients who had SLI and another series of 9 patients with ASD, in order to determine whether MEG is capable of distinguishing these diagnoses. RESULTS: Patients with SLI displayed pathological activity in the frontal and middle temporal regions of both hemispheres. Patients with ASD showed pathological activity in the perisylvian area. Expressive-receptive SLI with pragmatic language disorder showed pathological activity that was similar to that seen in autism. CONCLUSION: MEG can be used to distinguish between SLI and ASD by studying the epileptiform activity that occurs in pervasive developmental disorders. MEG helps us to understand the continuum that exists between SLI or expressive-receptive SLI and autism.

Autistic Disorder↗

[Stigmatization of language impaired children from the parents' perspective].

Stigmatization can strongly affect the social integration of children and adolescents with developmental and behavioral disorders. The goal of the study was to investigate negative and positive labeling of speech-language impaired children as perceived by their parents. We analyzed 386 parental questionnaires on stigmatization by and support from other children, family members and other adults. Half of the parents reported stigmatization of their child. They perceived negative labeling and exclusion most frequently in the child's peer group, but also among family members. Support was more common than negative labeling, however. There was a strong positive relationship between negative labeling and behavioral problems. Parents of children with developmental and behavioral disorders often perceive stigmatization of their child. Therefore, in counseling such families child and adolescent psychiatrists should address this issue adequately and recommend appropriate coping strategies.

Adaptation, Psychological↗

Observations of the role relations and behavior between older children with mental retardation and their younger siblings.

Children with mental retardation and their younger siblings without retardation were observed interacting in three naturally occurring in-home contexts (toy play, television viewing, and snack). Comparison siblings without retardation who were matched on age, sex, race, parental marital status, education, and family income were also observed. Interactions between children with retardation and their siblings were characterized by accentuated role asymmetries that favored the younger siblings, whereas the older siblings were dominant in the comparison group. No differences in affect were found between the sibling groups. The competence of the child with mental retardation reliably predicted sibling role asymmetries, and the observational contexts influenced sibling behavior in both groups. Gender differences in roles and behavior were minimal.

Activities of Daily Living↗

[Incidence of psychiatric symptoms in 4- to 8-year-old children with unintelligible speech].

Twenty-four children between 4 years 5 months and 8 years of age with unintelligible spontaneous speech and at least average nonverbal intelligence were evaluated over a period of several hours. Nine of the children (37%) were found to have a psychiatric disorder, either a disturbance of emotions specific to childhood (ICD code 313) or a hyperkinetic syndrome (ICD code 314). No relationship was found between the presence of such a disorder and the severity of the speech/language disorder.

Affective Symptoms↗

[Early childhood autism from the behavioral biologic and neurophysiologic viewpoint].

Assuming that the autistic syndromes my be attributed to disturbances in information input and processing, the results of the most important behavioural and neurophysiological investigations made during the past 10 to 15 years are introduced and discussed in brief. Etiological questions are raised, too. Disturbed perception in different sensory systems may also be considered as partial disablement. The environment's reaction to the disturbances potentiates the child's disturbed communication with the environment. It is pointed to that similar behavioural patterns are also known from animal etiology. The autism in early infancy may be a sign of disturbed assessment of reality as well.

Autistic Disorder↗

Physical illness, pain, and problem behavior in minimally verbal people with developmental disabilities.

There is growing interest in the role that physical illness and pain might play in exacerbating problem behavior in individuals with developmental disabilities. Assessment of these factors, however, is often difficult since many individuals have minimal verbal communication skills. In response to this difficulty, we developed a sequential method of assessment involving retrospective and prospective measurement strategies. We found that the frequency and intensity of problem behavior was greater on "sick" days than on "well" days. Further, the higher the level of pain, the greater was the frequency and intensity of problem behavior. We discuss the concept of pain as a setting event for problem behavior and the intervention strategies that follow from this conceptualization.

Adolescent↗

The theory of an agnosic right shift gene in schizophrenia and autism.

The right shift (RS) theory (Annett, M., 1972. The distribution of manual asymmetry. Br. J. Psychol. 63, 343-358; Annett, M., 1985. Left, Right, Hand and Brain: The Right Shift Theory. Lawrence Erlbaum, London) suggests that the typical pattern of human cerebral and manual asymmetries depends on a single gene (RS+) which impairs speech-related cortex of the right hemisphere. The theory offers solutions to several puzzles, including the distribution of handedness in families (Annett, M., 1978. A Single Gene Explanation of Right and Left Handedness and Brainedness. Lanchester Polytechnic, Coventry; Annett, M., 1996. In defense of the right shift theory. Percept. Motor Skills 82, 115-137), relations between handedness and cerebral speech laterality (Annett, M., 1975. Hand preference and the laterality of cerebral speech. Cortex 11, 305-328; Annett, M., Alexander, M.P., 1996. Atypical cerebral dominance: predictions and tests of the right shift theory. Neuropsychologia 34, 1215-1227) and handedness and dyslexia (Annett, M. et al., 1996. Types of dyslexia and the shift to dextrality. J. Child Psychol. Psychiatry 37, 167-180). If Crow's (Crow, T.J. et al., 1989. Schizophrenia as an anomaly of development of cerebral asymmetry. A postmortem study and a proposal concerning the genetic basis of the disease. Arch. Gen. Psychiatry 46, 1145-1150; Crow, T.J., 1997. Is schizophrenia the price that Homo sapiens pays for language? Schizophr. Res. 28, 127-141) theory that schizophrenia is due to an anomaly of cerebral dominance is correct, and if the RS theory is correct, schizophrenia could be due to an anomaly of the RS+ gene. If the RS+ gene were at risk for a mutation which caused a loss of directional coding, the mutant could be described as 'agnosic' for left and right. Such a gene would impair either hemisphere at random. When paired with another RS+ gene, both hemispheres would be impaired in 50% of cases. The other 50% and people in whom the agnosic gene is paired with an RS-allele (neutral for asymmetry and not giving hemisphere impairment) would have one unaffected hemisphere and, thus, normal development. Quantitative predictions based on the RS genetic theory as previously developed, plus an agnosic mutant with frequency required to give schizophrenia in 1% of the population, are consistent with estimates of concordance for schizophrenia in relatives. Homozygotes of the agnosic mutant would occur at about the rate estimated for autism.

Autistic Disorder↗

Auditory processing and the development of language and literacy.

This paper considers evidence for basic auditory processing impairments associated with dyslexia and specific language impairment, against a back-drop of findings from studies of the normal development of auditory and phonological processing. A broad range of auditory impairments have been implicated in the aetiology of these language-learning disorders, including deficits in discriminating the temporal order of rapid sequences of auditory signals, elevated thresholds for frequency discrimination and for detection of amplitude and frequency modulation, impaired binaural processing and increased susceptibility to backward masking. Current evidence is inconsistent, but suggests that not all children with language difficulties have non-verbal auditory processing impairments, and for those that do, the impact on language development is poorly understood. Some implications for clinical practice are discussed.

Auditory Perception↗

Autism screening questionnaire: diagnostic validity.

BACKGROUND: Good interview and diagnostic measures for autism and other pervasive developmental disorders (PDDs) are available but there is a lack of a good screening questionnaire. AIMS: To develop and test a screening questionnaire based on items in the best available diagnostic interview--the Autism Diagnostic Interview--Revised (ADI-R). METHOD: A 40-item scale, the Autism Screening Questionnaire (ASQ), was developed and tested on a sample of 160 individuals with PDD and 40 with non-PDD diagnoses. RESULTS: The ASQ has good discriminative validity with respect to the separation of PDD from non-PDD diagnoses at all IQ levels, with a cut-off of 15 proving most effective. The differentiation between autism and other varieties of PDD was weaker. CONCLUSIONS: The ASQ is an effective screening questionnaire for PDD.

Adolescent↗

Stuttering: a review of research findings and theories circa 1982.

The research literature on stuttering is extensive, spanning etiology, natural history, phenomenology, and treatment. In this review, existing empirical knowledge is distilled by attending only to replicated findings. These are designated as "facts." Facts concerning the natural history of idiopathic stuttering highlight early childhood onset, probability of recovery, and importance of a positive family history of stuttering. Corroborated evidence on stutterer-nonstutterer differences concerns intelligence distribution, speech development, central auditory function, and sensory-motor response. Predictable changes in stuttering frequency, and even total elimination of stuttering, occur under a remarkable variety of conditions. Review of therapies revealed two that satisfied the most stringent criteria for good treatment. Various theoretical positions are examined for their fit with the established facts. A model of stuttering as a genetically determined reduction in central capacity for efficient sensory-motor integration is preferred, provided acquisition of secondary symptoms is attributed to instrumental learning.

Adult↗

Developmental setback in severe visual impairment.

Developmental setback in children initially thought to be of normal cognitive potential is a serious complication of severe visual impairment; the prevalence, diagnostic specificity, clinical presentation, and factors that contribute to its genesis require systematic investigation. The findings are reported of a retrospective case review over a 15 year period of children attending the developmental vision clinic at the Wolfson Centre of the Institute of Child Health. One hundred and two children met the inclusion criteria of a period of normal development confirmed at initial assessment when aged less than 16 months, absence of additional disabilities, and follow up to at least 2.5 years of age. Developmental setback in their second or third year occurred in 10 (31%) of 32 children who were totally blind throughout (minimal perception of light or less), one (4%) of 25 who, though blind at first assessment, showed visual improvement, and none of 49 children with better vision throughout (awareness for near, large objects). This represents a significantly greater risk for totally blind children than for the other groups. The course and characteristics of the affected children varied, but all had visual diagnoses involving the nervous elements of the visual system, and 60% had major social adversity factors. The role of primary maldevelopment of the central nervous system, the degree of visual impairment, the developmental and emotional climate, and the stage of attentional and behavioural development in the causation of adverse developmental outcome are discussed.

Autistic Disorder↗

[Child development after abdominal version of the fetus from breech presentation to vertex presentation near term].

The prospective study presented here describes the results of follow-up examinations of the developmental stage of 116 children born between 1977 and 1980 in whom abdominal version of the foetus from breech presentation to vertex presentation was performed near term. The children were examined according to the Denver Developmental Screening Test at the age of 2 to 5 3/4 years in various fields (social contacts, minor motor functions and adaptation, speech and major motor functions). Children with abnormal findings were subjected to special examinations. Those with disturbed development were re-examined after one year. In the entire group of children there were four with psychomotor retardation of speech, and two further children with minimal cerebral motor disturbances. The children had been detected early during infancy. These results, classified as secondary morbidity (disturbances of speech and minimal cerebral motor disturbances) were analysed taking into account the results of version (successful and unsuccessful version) and other obstetric factors (course of pregnancy and birth, method of delivery, biochemical examinations during and after birth, age of mother and socioeconomic status of parents).

Attention Deficit Disorder with Hyperactivity↗