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Results for “Child Development Disorders, Pervasive”

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PubMed1991

Stressors experienced by family caregivers of children with pervasive developmental disorders.

The purpose of this study was to identify the perceived stressors experienced by parents who care for children with Pervasive Developmental Disorders. The relationship between demographics and overall stress was also examined. The most frequently cited stressor was difficulty arranging for and collaborating with professional and support services. Problems associated with the child's emotional and mental state were viewed as the most stressful of all. No demographic variables showed a significant relationship to degree of overall stress.

Adult↗

PubMed1990

Acquired aphasia with convulsive disorder: a pervasive developmental disorder variant.

A 5 1/2-year-old boy with language delay and behavioral problems was evaluated. His symptoms were consistent with pervasive developmental disorder, and electroencephalography showed frequent generalized spike and polyspike activity. After therapeutic levels of anticonvulsant medication were achieved, improvement was noted in communication skills and behavior, as well as on the electroencephalogram. Although the response of language dysfunction to these drugs has been generally disappointing in previously reported cases of communication disorders associated with electroencephalographic abnormalities, a trial of anticonvulsant medication is probably warranted.

Aphasia↗

PubMed2006

Pervasive developmental disorder, behavior problems, and psychotropic drug use in children and adolescents with mental retardation.

OBJECTIVE: This study investigated the interrelationship between psychopharmacotherapy in general and the use of specific psychotropic drugs and pervasive developmental disorder and other behavior problems in children and adolescents with mental retardation. METHODS: A total of 862 participants 4 to 18 years of age, including all levels of mental retardation, were recruited through facilities for children with mental retardation in Friesland, The Netherlands. Information on medication was collected through parent interviews. Behavior problems were investigated with a standardized parent questionnaire (Developmental Behavior Checklist). A pervasive developmental disorder classification was based on the Pervasive Developmental Disorder in Mental Retardation Scale, completed by psychologists or teachers. Logistic regression analysis was used to investigate the relationship between the use of psychotropic drugs and pervasive developmental disorder and other behavioral problems, in the presence of possible confounders. RESULTS: One of 10 participants used psychotropic medication. The main factors associated with psychotropic drug use were pervasive developmental disorder and disruptive behavior. The level of functioning was also associated. Self-absorbed behavior was statistically significantly associated with clonidine use and disruptive behavior with stimulant use. Pervasive developmental disorder and communication problems were the main factors associated with the use of antipsychotic drugs. Age also played a role, whereas gender, living situation, and level of mental retardation did not. CONCLUSIONS: Antipsychotic drugs were associated with pervasive developmental disorder, whereas clonidine and stimulants were associated with self-absorbed and disruptive behavior, respectively. Although clonidine and risperidone are not registered for the problems reported and the other nonstimulants were only sometimes used on-label, their use was associated with specific psychiatric or behavioral problems.

Adolescent↗

PubMed2003

Functional neuroimaging of social cognition in pervasive developmental disorders: a brief review.

An emerging literature on the neuroanatomical correlates of social cognition in pervasive developmental disorders is reviewed. Studies conducted with high-functioning adults with autism or Asperger's syndrome highlight patterns of decreased activation in ventromedial prefrontal cortex, temporo-parietal junction, amygdala, and periamygdaloid cortex, along with aberrantly increased activation in primary sensory cortices. Future studies should extend these important initial results to younger and more severely affected subjects.

Adult↗

PubMed1994

Reliability of the KIDIES for diagnosing pervasive developmental disorder in children.

The Kiddie-Infant Descriptive Instrument for Emotional States (KIDIES), a new instrument that uses affective and behavioral dimensions for categorization, was compared with DSM-III-R criteria to assess diagnostic reliability in childhood pervasive developmental disorder (PDD). Forty-two children with PDD and other developmental disorders were evaluated. Their diagnoses were based on DSM-III-R criteria. Subjects were videotaped during interviews with three different partners and rated using the KIDIES. Cluster analysis of KIDIES ratings revealed a significant correlation with DSM-III-R diagnostic categories, demonstrating the potential reliability of the KIDIES dimensional approach for diagnosing PDD in preschoolers.

Child Development Disorders, Pervasive↗

PubMed1998

Autism and related disorders: epidemiological findings in a Norwegian study using ICD-10 diagnostic criteria.

Recent studies of the prevalence of autism have suggested higher estimates than previously described. Various diagnostic criteria for autism and related disorders have been applied, with variability in case finding methodology and characteristics of populations as well. In this study, maternal and child health clinics covering 98% of the population were used for screening pervasive developmental disorders. Extensive medical investigation was carried out on the majority of cases. In this Norwegian population of children ages 3-14 years the minimum prevalence estimate for childhood autism was 4-5 per 10,000 using ICD-10 research criteria, and did not confirm the high estimates suggested more recently. Medical disorders identified were associated with mental retardation rather than specifically with autism.

Adolescent↗

PubMed1996

Head circumference in autism and other pervasive developmental disorders.

Recent studies have found that an unexpectedly large proportion of autistic children have large heads. Anthropometric measures of consecutive clinic attenders with pervasive developmental disorder (PDD), other psychiatric or language disorders were analysed. Similar data were obtained from two schools for language disordered children. These data, combined with those from previous studies, indicate that about one-third of children with PDD have macrocephaly based on current percentile charts; this rate was significantly higher than in children with language disorder alone. The finding was not a consequence of recognizable medical disorders and suggests that PDD is sometimes associated with abnormal physical development.

Anthropometry↗

PubMed2005

Pervasive developmental disorders rating scale: development and construct validity.

The Pervasive Developmental Disorders Rating Scale was designed for use in screening of pervasive developmental disorders. This paper describes the rationale and development of the scale and assesses its construct validity with ratings from a sample of 362 children ranging in age from 1 to 12 years and diagnosed with autistic disorder. The hypothesized heirarchical factor model and two competing models were examined through confirmatory factor analysis. The analysis supported the factor structure of the hypothesized model in this particular sample of children with autistic disorder. Limitations and areas for research are discussed.

Affect↗

PubMed2004

Supernumerary tricentric derivative chromosome 15 in two boys with intractable epilepsy: another mechanism for partial hexasomy.

Rearrangements of chromosome 15q, including isodicentric 15 chromosomes and interstitial duplications and triplications, have been previously reported in association with autism spectrum disorders. We have identified two boys with exceptionally large der(15) chromosomes that are tricentric and contain four copies of the proximal long arm, including the Prader Willi/Angelman critical region, and leading to hexasomy of the involved segment. Biallelic inheritance of maternal alleles and methylation analysis indicate that the markers are maternally derived. Clinical assessment of the boys indicated severe cognitive impairment associated with marked delays in gross and fine motor skills. Social and language deficits were present in both, although the severity of the mental retardation precluded diagnosis of autism (both were considered to have pervasive developmental disorder-not otherwise specified). Neurologic manifestations included infantile spasms evolving into intractable early-onset myoclonic seizures, psychomotor regression, and profound diffuse hypotonia. These patients represent the most severe end of the spectrum of phenotypes associated with segmental aneuploidy for chromosome 15q11-q13.

Abnormalities, Multiple↗

PubMed1992

Is Rett syndrome a subtype of pervasive developmental disorders?

The author reviews the issue on whether Rett syndrome (RS) is a subtype of pervasive developmental disorders (PDDs). More than 200 articles of RS have been published in the last 10 years. Internal and external validities of RS have been established by several independent studies. There remains the question whether RS presents clinical features that meet the total criteria for PDDs. The available data seem to support the idea of classifying RS as a subtype of PDDs in the DSM-IV.

Child↗

PubMed2001

Pervasive developmental disorders and GABAergic system in patients with inverted duplicated chromosome 15.

Pervasive developmental disorders are characterized by severe, pervasive impairment in several areas of development, with distorted communication skills and stereotypical behavior. Pervasive developmental disorders have a heterogeneous etiology related to brain damage, familial affective psychopathology, chromosomal abnormalities, or dysfunction of neuromodulators. Recently, it has been suggested that the GABRB3 gene, located within chromosome 15q11-13, is a candidate for pervasive developmental disorder. In inverted duplicated chromosome 15 syndrome, in which there is a small marker chromosome derived from inversion and duplication of the chromosome 15q11-q13 region, all patients present with pervasive developmental disorder. To further investigate a possible involvement of the gamma-aminobutyric acid (GABA)ergic system in the inverted duplicated chromosome 15 syndrome, we evaluated plasma levels of GABA and diazepam binding inhibitor in 6 patients with inverted duplicated chromosome 15 and in 8 subjects not affected by neurologic disease. Our findings do not seem to support this hypothesis as no significant differences were found in the GABA and diazepam binding inhibitor plasma levels between patients with inverted duplicated chromosome 15 and controls, but we must consider the possibility that a genetic abnormality of the GABA(A) receptor could be present in patients with inverted duplicated chromosome 15 and still not be reflected in an alteration in either GABA or diazepam binding inhibitor levels in plasma.

Adolescent↗

PubMed1995

Psychiatric disorders in pre-schoolers.

The psychiatric disorders seen in preschoolers are reviewed. Behaviour problems are the most commonly seen. These may be due to reaction to stress, developmental problems of attachment and temperamental characteristics such as shyness and aggressiveness. Related to behavioural problems are the developmental disorders of enuresis, encopresis and constipation. The rate of behaviour problems in Singapore was found to be 7% which compares favourably with studies overseas. Disorders that have their onset in the preschool period include Attention Deficit Hyperactivity Disorder (ADHD) and Pervasive Developmental Disorders. ADHD is increasingly important because of the response to Ritalin and pervasive disorders because of the recognition that autistic states probably cover a spectrum of disorders. Aetiological factors of preschool psychiatric disorders include biological and psychosocial contribution. The latter is associated with the quality of the home environment and quality of care experienced by the child. Assessment methods include the gathering of developmental data such as the IQ and appropriate behavioural checklists. Direct observation is increasingly practised. Management methods range from drug therapy (mainly in ADHD), to traditional psychodynamic, family and behavioural therapy.

Age Factors↗

PubMed1999

Exploring the boundaries of pervasive developmental disorder not otherwise specified: analyses of data from the DSM-IV Autistic Disorder Field Trial.

This study aimed to explore the boundaries between PDD and related disorders and to develop classificatory algorithms for what is currently called Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS). Data collected by means of a standard coding system for the DSM-IV field trial for autistic disorder were used. Information on diagnostic criteria for autistic disorder as listed in ICD-10 and DSM-IV was compared between subjects functioning at least in the mildly retarded range and clinically classified as autistic disorder (n = 205), PDDNOS (n = 80) and other non-PDD disorders (n = 174). Only a limited number of items from the ICD-10 and DSM-IV systems for autistic disorder significantly discriminated the PDDNOS group from other disorders. A scoring rule based on a short set of 7 ICD-10/DSM-IV criteria with a cutoff of 3 items and 1 social interaction item set as mandatory had the best balance between high sensitivity and high specificity in discriminating PDDNOS from non-PDD disorders. These rules yielded a somewhat better prediction than most effective rules based on the full set of 12 criteria for autistic disorder with a cutoff of 4 items and 1 social item as mandatory. Generally accepted and well-validated criteria to identify individuals with PDDNOS should facilitate both research and clinical services.

Adolescent↗

PubMed1996

Lead intoxication in children with pervasive developmental disorders.

OBJECTIVE: To investigate the observation that children with pervasive developmental disorders have later and more prolonged lead exposure and are more likely to be reexposed when compared to lead-poisoned children without pervasive developmental disorders. DESIGN: Retrospective chart review. SETTING: A large, urban lead treatment program. RESULTS: Over a six year period 17 children with pervasive developmental disorders (including autism) were treated. Compared to a randomly selected group of 30 children without pervasive developmental disorders who were treated for plumbism over the sam interval, those with pervasive developmental delay were significantly older at diagnosis (46.5 vs 30.3 months, p = .03) and had a longer period of elevated blood lead levels (39.1 vs 14.1 months, p = .013) during management. Despite close monitoring, state-mandated environmental inspection and prompt lead hazard reduction or alternative housing, 75% of children with pervasive developmental disorders were reexposed to lead during medical management compared with 23% of children without pervasive developmental disorders (p = .001). CONCLUSIONS: 1) lead intoxication among children with pervasive developmental disorders may appear de novo beyond the third year of life and is associated with a high rate of reexposure; 2) the provision of deleaded housing (by current techniques) may not be sufficient to protect these children from repeated lead exposure; 3) these data support recommendations by the Centers for Disease Control that children with developmental delays be closely monitored for the appearance of lead intoxication. This monitoring should continue beyond the third year of life.

Chelating Agents↗

PubMed1993

Subclassification of children with autism and pervasive developmental disorder: a questionnaire based on Wing's subgrouping scheme.

A questionnaire (the Wing Subgroups Questionnaire, or WSQ) for subclassifying children with autism into one of Wing's three hypothesized subgroups was developed, and the validity of this measure was assessed. Forty parents of children with autism or pervasive developmental disorder not otherwise specified (PDDNOS) completed the questionnaire. Results indicated that the questionnaire has adequate external criterion-referenced validity with similar subgroup ratings made by clinicians, and good internal consistency. Furthermore, results revealed three distinct and separate subgroups corresponding to Wing's subclassification scheme. Other analyses suggested that Wing assignment based on the WSQ was independent of chronological age and age equivalents for social and daily living skills, but not independent of diagnosis of autism vs. PDDNOS, IQ, severity of autism, sex, receptive language mental age, and age equivalents for communication skills. Finally, a discriminant analysis indicated that, of all the dependent variables examined in the present study, the clinicians' Wing assignment was the best predictor of Wing assignment based on the parent-completed WSQ. These findings provide support for Wing's classification system, and suggest that the WSQ is a valid and useful tool for subclassifying individuals with autism.

Adolescent↗

PubMed1989

[Children with autism and related contact disorders: medical aspects].

In children with infantile autism or atypical pervasive developmental disorders somatic aspects play an important role. A review is presented of important hereditary, pre-, peri- and neonatal factors, findings at neurological examination, specific medical disorders and neurochemical and neurophysiological findings. Results of the medical examination of 15 children with autistic or atypical developmental disorders are presented. It is concluded that extensive medical examination of these children is indicated: in 8 out of 15 children a clinically relevant chromosomal, neurological or biochemical disorder could be detected.

Autistic Disorder↗

PubMed2004

Phenomenology and epidemiology of childhood psychiatric disorders that may necessitate treatment with atypical antipsychotics.

Children and adolescents commonly present to clinical settings with more severe psychopathology than previously recognized. Physicians evaluating children may be confronted with clinical manifestations of early-onset schizophrenia, including command hallucinations and delusional thinking, severe irritability and suicidality associated with juvenile-onset bipolar disorder, or the severe aggression of a child with a pervasive developmental disorder. In these as well as other clinical situations, the potential risks and benefits of treatment with atypical antipsychotics should be considered. In this article, we summarize the clinical manifestations of psychiatric disorders in children and adolescents, with particular attention to the disorders for which the benefits of prescribing an atypical antipsychotic may outweigh the potential risks. We also describe the differences in the clinical presentation of these disorders between youth and adults.

Adolescent↗

PubMed2004

Autism spectrum disorder in fragile X syndrome: communication, social interaction, and specific behaviors.

The present study extends our previous work on social behavior impairment in young males with fragile X syndrome (FraX). Specifically, we evaluated whether the autistic phenomenon in FraX is expressed as a range of behavioral impairments as in idiopathic autism (Aut). We also examined whether there are behaviors, identified as items of the Autism Diagnostic Interview-Revised (ADI-R), that in FraX predispose to or differentiate subjects with autism spectrum disorder (ASD) diagnosis. Finally, regression models were utilized to test the relative contribution of reduced communication and socialization skills to ADI-R scores and diagnoses. A cohort of 56 boys (3-8 years) with FraX was examined in terms of scores on measures of cognition (IQ was a co-variate in most analyses.), autistic behavior, problem/aberrant behavior, adaptive behavior, and language development. We found that, indeed, in terms of problem behavior and adaptive skills, there is a range of severity from FraX + Aut to FraX + PDD (Pervasive Developmental Disorder) to FraX + none. ADI-R items representing "Play" types of interaction appear to be "susceptibility" factors since they were abnormal across the FraX cohort. Integrated regression models demonstrated that items reflecting complex social interaction differentiated the FraX + ASD (Aut + PDD) subgroup from the rest of the FraX cohort, while abnormalities in basic verbal and non-verbal communication distinguished the most severely affected boys with FraX + Aut from the milder FraX + PDD cohort. Models incorporating language, adaptive communication, and adaptive socialization skills revealed that socialization was not only the main influence on scores but also a predictor of ASD diagnosis. Altogether, our findings demonstrate that the diagnosis of ASD in FraX reflects, to a large extent, an impairment in social interaction that is expressed with variable severity in young males with FraX.

Adaptation, Psychological↗