Epilepsy in patients with pervasive developmental disorder not otherwise specified

Data on epilepsy in pervasive developmental disorder not otherwise specified are few and scanty. Seventy-seven patients with pervasive developmental disorder not otherwise specified were compared with 77 with autistic disorder, matched for age and sex. The 2 groups were divided into 3 subgroups each: A, without electroencephalography (EEG) paroxysmal abnormalities or epilepsy; B, with EEG paroxysmal abnormalities without epilepsy; and C, with epilepsy. Mild mental retardation (P < .01), pathological neurological examination (P < .05), cerebral lesions (P < .01), abnormal EEG background activity (P < .001), and associated genetic pathologies (P < .01) were more common in pervasive developmental disorder not otherwise specified. Familial antecedents for epilepsy prevailed in subgroup C (P < .01). Epilepsy occurred in 35.1% of patients with pervasive developmental disorder not otherwise specified, with no statistically significant difference compared with autistic disorder. The mean age of seizure onset was earlier (2 years 8 months) in pervasive developmental disorder not otherwise specified (P < .000). Seizure outcome was better in autistic disorder. Genetic diseases and cerebral lesions should be investigated in pervasive developmental disorder not otherwise specified to clarify the etiological and clinical features.     

Face recognition in children with a pervasive developmental disorder not otherwise specified

This study investigates the accuracy and speed of face recognition in children with a Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS; DSM-IV, American – Psychiatric Association [APA], 1994). The study includes a clinical group of 26 nonretarded 7- to 10-year-old children with PDDNOS and a control group of 65 normally developing children of the same age. Two computerized reaction time tasks were administered: a face recognition task and a control task designed to measure the recognition of abstract visuospatial patterns. The latter were either easy or difficult to distinguish from a set of alternative patterns. The normally developing children recognized the faces much faster than the hardly distinguishable abstract patterns. The children in the PDDNOS group needed an amount of time to recognize the faces that almost equalled the time they needed to recognize the abstract patterns that were difficult to distinguish. The results suggest that, when processing faces, children with PDDNOS use a strategy that is more attention-demanding and, hence, less automatic or Gestalt-like than the one used by the control children. The results are discussed in the light of a theory that explains the development of coherent mental representations.     

Cognitive profiles of adults with Asperger's disorder, high-functioning autism, and pervasive developmental disorder not otherwise specified based on the WAIS-III

Little is known about the cognitive profiles of high-functioning Pervasive Developmental Disorders (PDD) in adults based on the Wechsler Intelligence Scale III (WAIS-III). We examined cognitive profiles of adults with no intellectual disability (IQ > 70), and in adults with Asperger's disorder (AS; n = 47), high-functioning autism (HFA; n = 24), and pervasive developmental disorder not otherwise specified (PDDNOS; n = 51) using the WAIS-III. Verbal Intelligence (VIQ)-Performance Intelligence (PIQ) differences were detected between the three groups. Full Intelligence (FIQ) and VIQ scores were significantly higher in AS than in HFA and PDDNOS. Vocabulary, Information, and Comprehension subtest scores in the Verbal Comprehension index were significantly higher in AS than in the other subgroups, while Digit-Symbol Coding and Symbol Search subtest scores in the Processing Speed index were significantly lower in HFA. The findings demonstrated cognitive profiles characteristic of adults with high-functioning PDD.     

Comparison of developmental/intellectual changes between autistic disorder and pervasive developmental disorder not otherwise specified in preschool years

This study is the first to compare the change in developmental quotient (DQ) or IQ between autistic disorder (AD) and pervasive developmental disorder not otherwise specified (PDDNOS) in preschool years. Forty-nine AD children and 77 PDDNOS children were evaluated at age 2 and at age > or =5. The AD children were significantly lower in DQ/IQ at initial evaluation and outcome evaluation (also with initial DQ being controlled for) than the PDDNOS children.     

Neutral versus emotional human stimuli processing in children with pervasive developmental disorders not otherwise specified

Pervasive developmental disorder not otherwise specified (PDD-NOS) represents up to two-thirds of autism spectrum disorders; however, it is usually described in terms of the symptoms not shared by autism. The study explores processing of neutral and emotional human stimuli (by auditory, visual and multimodal channels) in children with PDD-NOS (n = 10) compared to typically developing children (n = 35). The neutral human stimuli consisted of faces and common first names. The emotional human stimuli consisted of happy, sad, angry, and neutral faces and vocalizations. The results confirmed previous findings and led to others. The PDD-NOS group (a) accurately processed neutral human stimuli; (b) had difficulty processing emotional stimuli in general and more easily identified happy compared to angry or neutral faces and vocalizations; (c) had a strong discrepancy between emotional and neutral human stimuli processing; (d) used the multimodal channel to compensate for unimodal deficits, especially for angry faces; and (e) was strongly heterogeneous.     

Relationship between motor and executive functioning in school-age children with pervasive developmental disorder not otherwise specified

This study examines the motor skills and executive functioning (EF) of 28 children diagnosed with pervasive developmental disorder-not otherwise specified (PDD-NOS; mean age: 10 years 6 months, range: 7-12 years; 19 boys, 9 girls) in comparison with age- and gender-matched typically developing children. The potential relationship between motor performance and EF in children with PDD-NOS is investigated as well. The children's motor skills were evaluated with the Movement ABC. EF, in terms of planning ability, strategic decision making, and problem solving, was gauged with the Tower of London (TOL) task. Compared with their typically developing peers, the children with PDD-NOS scored poor on the Movement ABC (p < 0.01) and the TOL (p < 0.05). They had significantly more definite motor problems than the normative sample of the Movement ABC: 43% (manual dexterity, p < 0.001), 25% (ball skills, p < 0.001), and 25% (balance skills, p < 0.001). There were significant inverse relationships between manual dexterity and the TOL score (r = −0.46, p < 0.01), and balance and the TOL score (r = −0.41, p < 0.05), indicating that children with a better performance on the manual dexterity subtest and the balance subtest had a better TOL score than children with a worse performance. Children with PDD-NOS have inferior motor skills, and these deficits are interrelated with planning ability, strategic decision making, and problem solving.     

Cognitive profile difference between normally intelligent children with Asperger's disorder and those with pervasive developmental disorder not otherwise specified

Aim: Asperger's disorder (Asperger syndrome, AS) and pervasive developmental disorder not otherwise specified (PDD‐NOS) are different subtypes of mild pervasive developmental disorders (PDD). Methods: Using the Japanese version of the Wechsler Intelligence Scale for Children–Third Edition (WISC‐III), 28 AS children (mean age, 9.3 years, 24 male) were compared with 78 PDD‐NOS children (mean age, 7.6 years, 64 male) with normal intelligence (IQ ≥ 85), using analysis of covariance (ancova ) with the chronological age of a child as a covariate. Results: Verbal IQ tended to be higher in the AS children than in the PDD‐NOS children (mean raw scores, AS vs PDD‐NOS: 103.9 vs 99.6; P < 0.10), although full‐scale and performance IQ did not differ significantly. Compared with the PDD‐NOS children, the AS children scored significantly higher on Freedom from Distractibility index (110.1 vs 104.5; P < 0.05) consisting of Arithmetic (11.0 vs 9.9, P = 0.04) and Digit Span (12.4 vs 11.6, P = 0.051), but tended to score lower on Coding (8.5 vs 9.8, P = 0.08). Conclusion: The typical cognitive profile of PDD (i.e. low score on Comprehension and high score on Block Design) was shared by both groups, which may support the validity of the current diagnostic classification of PDD. Relatively better verbal ability in AS children seems to reflect their normal language acquisition in infancy, and strong numeric interest may produce the AS children's mathematical excellence over PDD‐NOS children. A low score on Coding in AS children might reflect their extreme slowness, circumstantiality and/or drive for perfection.     

Social and communication behaviours in infants and toddlers with autism and pervasive developmental disorder-not otherwise specified

Purpose: Autism Spectrum Disorders (ASD) are a group of conditions characterized by symptoms that onset in early childhood. Deficits in social skills and communication are two of the core features of ASD and, if not remediated, can lead to poor long-term outcomes. Few researchers have examined characteristics of social skills and communication in infants with ASD.

Method: The social skills and communicative ability of 886 infants and toddlers 17–37 months of age with autism, PDD-NOS or ‘at risk’ for other developmental delays were evaluated using the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT). A Kruskal-Wallis test with follow-up Mann-Whitney tests were used to test for significance.

Results: Infants and toddlers with autism, followed by PDD-NOS, had greater social and communication deficits than children ‘at risk’ for developmental delays. Items which distinguished between these diagnostic groups were determined.

Conclusions: Outcomes suggest that social and communication deficits can be identified at early ages in a population of developmentally delayed toddlers. Implications are that pinpointing emerging social and communicative autistic traits earlier will allow for more accurate assessment and diagnosis in infants with ASD. This translates into earlier intervention and more effective treatment practices.     

Cardiac adaptivity to attention-demanding tasks in children with a pervasive developmental disorder not otherwise specified (PDD-NOS).

BACKGROUND: Decreases in heart rate variability (HRV) have been repeatedly demonstrated to be an index of effort allocation to attention-demanding tasks. Children with autistic-type problems in social interaction and in adapting to unfamiliar situations (DSM-IV: PDD-NOS) have been shown to have specific attention deficits. These children were hypothesized to exhibit less cardiac adaptivity to attention-demanding tasks. METHODS: Two groups of 18 children with PDD-NOS, judged to be hyperactive and nonhyperactive, were compared to 18 healthy children with respect to their performances on a visual attention task and the differences in HRV measured during periods of task performance and periods of rest. RESULTS: Compared to the control group, both clinical groups were found to have a stronger capacity limitation in processing high loads of information, and to be less capable of maintaining a stable task performance throughout the whole task. Both clinical groups showed significantly less decreases in HRV during the periods of task performance. The magnitude of rest-task differences in HRV was found to correlate significantly with a behavioral measure of resistance to unexpected changes in daily routines. CONCLUSIONS: Children with PDD-NOS are significantly less flexible in their autonomic adaptation to attention-demanding tasks. The findings are interpreted as reflecting a deficiency in the functional organization of those neural pathways that provide cortical control of the visceral efferents.     

An examination of challenging behaviors in autistic disorder versus pervasive developmental disorder not otherwise specified: Significant differences and gender effects

Children with Autism Spectrum Disorders (ASDs) are well-known for engagement in challenging behaviors. Unfortunately, due to its absence as a criterion for diagnosis in the DSM-IV-TR, little attention has been paid to the endorsement rates of such behaviors. However, a recently developed measure to assist in the diagnosis of infants and toddlers with autism and PDD-NOS - the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT) - has included a section designated for just this reason. This study used the BISCUIT to assess for significant differences in the endorsement rates of challenging behaviors between infants and toddlers with autism versus PDD-NOS as well as for significant differences between genders. There were significant differences between the diagnostic groups in endorsement rates of challenging behaviors as a whole, as well as among many specific behavior items. No significant differences between genders in endorsement rates of challenging behaviors were found. The implications of these findings are discussed.     

Comorbid psychopathology in infants and toddlers with autism and pervasive developmental disorders-not otherwise specified (PDD-NOS)

The purpose of this study was to investigate symptoms of comorbid disorders in infants and toddlers with autism spectrum disorders (ASDs). Research is scant on symptoms of co-occurring mental health conditions in this very young population. Method: Three hundred and twenty four participants were included in this study. Participants were classified into one of three groups: Autistic Disorder, Pervasive Developmental Disorder-Not Otherwise Specified, and control. A Multivariate Analysis of Variance (MANOVA) was utilized to assess group differences on the six subscales of the Baby and Infant Screen for Children with aUtIsm Traits-Part 2 (BISCUIT-Part 2). Results: The MANOVA revealed a significant main effect for group. Follow-up analyses showed that all subscales contributed to the significant main effect of the MANOVA. Discussion: The results of the analyses in this study are consistent with the current literature on older children and adults with ASDs. Implications of early identification of comorbid disorders are discussed. Further research on the mental health of infants and toddler with autism spectrum disorders (ASDs) is warranted.     

Differences in finger length ratio between males with autism, pervasive developmental disorder-not otherwise specified, ADHD, and anxiety disorders

Children with autism have a relatively shorter index finger (2D) compared with their ring finger (4D). It is often presumed that the 2D:4D ratio is associated with fetal testosterone levels and that high fetal testosterone levels could play a role in the aetiology of autism. It is unknown whether this effect is specific to autism. In this study, 2D:4D ratios of 144 males aged 6 to 14 years (mean age 9y 1 mo [SD 1y 11 mo]) with psychiatric disorders were compared with those of 96 males aged 6 to 13 years from the general population (mean age 9y 1 mo [SD 1y 10 mo]). Psychiatric disorders were divided into autism/Asperger syndrome (n=24), pervasive developmental disorder-not otherwise specified (PDD-NOS; n=26), attention-deficit-hyperactivity disorder (ADHD)/oppositional defiant disorder (ODD; n=68), and anxiety disorders (n=26). Males with autism/Asperger syndrome (p<0.05) and ADHD/ODD (p<0.05) had significantly lower (though not significantly; p=0.52) ratios than males with an anxiety disorder, and males with autism/Asperger syndrome had lower ratios than those in the comparison group. These results indicated that higher fetal testosterone levels may play a role, not only in the origin of autism, but also in the aetiology of PDD-NOS and of ADHD/ODD. Males with anxiety disorders might have been exposed to lower prenatal testosterone levels.     

Common and unique impairments in facial-expression recognition in pervasive developmental disorder-not otherwise specified and Asperger's disorder

This study was designed to identify specific difficulties and associated features related to the problems with social interaction experienced by individuals with pervasive developmental disorder-not otherwise specified (PDD-NOS) using an emotion-recognition task. We compared individuals with PDD-NOS or Asperger's disorder (ASP) and typically developing individuals in terms of their ability to recognize facial expressions conveying the six basic emotions. Individuals with PDD-NOS and ASP were worse at recognizing fearful faces than were controls. Individuals with PDD-NOS were less accurate in recognizing disgusted faces than were those with ASP. The results suggest that PDD subtypes are characterized by shared and unique impairments in the ability to recognize facial expressions. Furthermore, the ability to recognize fearful but not disgusted expressions was negatively correlated with the severity of social dysfunction in PDD-NOS and ASP. The results suggest that impaired recognition of fearful and disgusted faces may reflect the severity of social dysfunction across PDD subtypes and the specific problems associated with PDD-NOS, respectively. Characteristics associated with different levels of symptom severity in PDD-NOS are discussed in terms of similarities with brain damage and other psychiatric disorders.     

Eating disorder not otherwise specified in adolescents

OBJECTIVE: To examine the frequency, type, and clinical severity of eating disorder not otherwise specified (EDNOS) in adolescents seeking treatment through an outpatient eating disorders service. METHOD: Two hundred eighty-one consecutive referrals to an eating disorders program were assessed using the Eating Disorder Examination (EDE) and self-report measures of depression and self-esteem. RESULTS: The majority of adolescents presented with EDNOS (59.1%; n = 166) relative to anorexia nervosa (AN; 20.3%; n = 57) and bulimia nervosa (BN; 20.6%; n = 58). Most EDNOS youths could be described as subthreshold AN (SAN; 27.7%; n = 46), subthreshold BN (SBN; 19.9%; n = 33), EDNOS purging (27.7%; n = 46), or EDNOS bingeing (6.0%; n = 10); yet 31 (18.7%) could not be categorized as such (EDNOS "other"). Overall differences in eating disorder pathology, depressive symptoms, and self-esteem emerged between the EDNOS types, wherein adolescents with EDNOS bulimic variants (SBN, EDNOS purging, and EDNOS bingeing) had more pathology than youths with SAN or EDNOS "other." There were no differences in these variables between AN and SAN; in contrast, compared with BN, youths with EDNOS bulimic variants reported lower EDE scores and higher self-esteem, although there were no between-group differences in depression. CONCLUSIONS: As in adults with eating disorders, EDNOS predominates and is heterogeneous with regard to eating disorder pathology and associated features in an adolescent clinical sample. Lack of differences between AN and SAN suggests that the strict criteria for AN could be relaxed; differences between BN and EDNOS bulimic variants do not support their combination.     

Motor skill abilities in toddlers with autistic disorder,pervasive developmental disorder-not otherwise specified,and atypical development

Motor skills were assessed in 397 toddlers, and it was demonstrated that atypically developing toddlers exhibited significantly greater motor skill abilities than toddlers with autistic disorder. No significant difference on gross or fine motor skill abilities were found between atypically developing toddlers and toddlers with pervasive developmental disorder-not otherwise specified (PDD-NOS), or between toddlers with autistic disorder and toddlers with PDD-NOS. Gross and fine motor skills were found to be more impaired for toddlers with autistic disorder compared to the atypical development group. Furthermore, differences in gross or fine motor skills between the autistic disorder and the PDD-NOS group approached significance. Approximate effect sizes were also calculated. Implications of the results are also discussed.