Minor physical anomalies in young psychotic children

The authors examined three groups of children for minor physical anomalies: 52 autistic children, 34 nonautistic siblings of these patients, and 29 normal controls. The total number of anomalies and the weighted score were significantly higher in the autistic children. The formation of these anomalies in the first three months of fetal life may concur with the developmental deviation of the central nervous system in some of these individuals.     

Minerals in the hair and nutrient intake of autistic children

The concentrations of calcium, magnesium, zinc, copper, lead, and cadmium were determined in scalp hair samples from a group of 12 autistic children and a group of 12 nonautistic control children. The only statistically significant difference between median concentrations of minerals in the hair from the two groups was a 62% decrease in the concentration of cadmium in the hair of autistic children. This decrease was probably not physiologically significant. The nutrient intake of autistic children as a group was found to be adequate and typical of well-fed American children. It was concluded that the children in neither the autistic nor the nonautistic control group showed evidence of toxicity or deficiency of the minerals or nutrients studied, but because of food idiosyncracies nutrient intake should be monitored.     

Developmental changes in brain serotonin synthesis capacity in autistic and nonautistic children

Serotonin content, serotonin uptake sites, and serotonin receptor binding measured in animal studies are all higher in the developing brain, compared with adult values, and decline before puberty. Furthermore, a disruption of synaptic connectivity in sensory cortical regions can result from experimental increase or decrease of brain serotonin before puberty. The purpose of the present study was to determine whether brain serotonin synthesis capacity is higher in children than in adults and whether there are differences in serotonin synthesis capacity between autistic and nonautistic children. Serotonin synthesis capacity was measured in autistic and nonautistic children at different ages, using alpha[11C]methyl-L-tryptophan and positron emission tomography. Global brain values for serotonin synthesis capacity (K complex) were obtained for autistic children (n = 30), their nonautistic siblings (n = 8), and epileptic children without autism (n = 16). K-complex values were plotted according to age and fitted to linear and five-parameter functions, to determine developmental changes and differences in serotonin synthesis between groups. For nonautistic children, serotonin synthesis capacity was more than 200% of adult values until the age of 5 years and then declined toward adult values. Serotonin synthesis capacity values declined at an earlier age in girls than in boys. In autistic children, serotonin synthesis capacity increased gradually between the ages of 2 years and 15 years to values 1.5 times adult normal values and showed no sex difference. Significant differences were detected between the autistic and epileptic groups and between the autistic and sibling groups for the change with age in the serotonin synthesis capacity. These data suggest that humans undergo a period of high brain serotonin synthesis capacity during childhood, and that this developmental process is disrupted in autistic children.     

Social class distribution of fathers of children enrolled in the Iowa Autism program

The social class distribution of fathers with autistic children attending a locally well-known and state-supported modern autism program was examined and was compared to the social class distributions observed in a nonautistic, mentally retarded population, in children with other psychiatric disorders, and in the general population from which the present autistic sample was drawn. No significant differences were found among the groups. The findings supported the view that if studies are not biased by certain selection factors outside the autistic child's clinical picture and diagnosis, and if services become better known and readily available, then no differences in social class distribution between autistic and nonautistic groups occur. The results suggest that social class is not an important factor in the origin of autistic syndrome.     

Monoamine oxidase activity in blood platelets from autistic children

In order to evaluate the possible abnormality in monoamine oxidase (MAO) activity in early infantile autism, blood platelet samples were obtained from 20 autistic children, aged 2--12 years. MAO activity, measured fluorometrically using serotonin as substrate, was 5.24 +/- 1.65 (Mean +/- Standard Deviation) nM/MG protein/hour in these autistic children. This value was not significantly different from either that in 30 age-matched normal children or that in 39 nonautistic children with various psychiatric and neurological disorders, although autistic children had higher platelet serotonin concentration than these nonautistic individuals.     

A comparison of obstetrical records of autistic and nonautistic referrals for psychoeducational evaluations

Heretofore most studies dealing with the association between perinatal complications and autism have used a normal comparison group. In this study obstetrical records of 59 autistic children were compared to those of 28 nonautistic children whose intelligence has a similar range and distribution as the autistic sample. Using an optimality score to reflect number of obstetrical complications, we found that the nonautistic controls experienced less optimal conditions than the autistic sample. Abnormal presentation at birth is the only factor that occurred more frequently for the autistic sample than control sample.We are grateful to our friends and colleagues, Sam Odom and Arthur Koch, for assistance with the statistical treatment of the data. We also acknowlege the support of Henry Schroeder, Director of the Institute for the Study of Developmental Disabilities.     

Monoamine Oxidase Activity in Blood-Platelets From Autistic Children

In order to evaluate the possible abnormality in monoamine oxidase (MAO) activity in early infantile autism, blood platelet samples were obtained from 20 autistic children, aged 2–12 years. MAO activity, measured fluorometrically using serotonin as substrate, was 5.24 ± 1.65 (Mean ± Standard Deviation) nM/mg protein/hour in these autistic children. This value was not significantly different from either that in 30 age-matched normal children or that in 39 nonautistic children with various psychiatric and neurological disorders, although autistic children had higher platelet serotonin concentrations than these nonautistic individuals.     

A comparative study of attachment behavior in young children with autism or other psychiatric disorders

The present study examined attachment behavior in children with autism and children with other developmental or psychiatric disorders. The groups were matched on chronological and mental age, IQ, and socioeconomic status. When a modified Strange Situation paradigm was used, no group differences were found in proximity seeking, contact maintenance, proximity avoidance, or contact resistance; the groups also did not differ in their overall security ratings. Attachment security was related to several developmental variables in the autistic group but not in the nonautistic comparison group. This suggests that attachment formation may involve different processes in autistic children than in nonautistic children of equivalent intellectual level.     

Social attachments in autistic children

Social responses of young autistic children to separation from and reunion with their caregivers did not differ from the social responses to similar situations of young mentally retarded nonautistic children. Most autistic children directed more social behaviors to their caregivers than to strangers and increased their preferential behavior after separation. Individual differences in social responses were not associated with the level of representational skills shown by the autistic children.     

Perception of human and nonhuman facial age by developmentally disabled children

Human and nonhuman faces were shown to clinical controls, autistic, mentally retarded, and language-disordered children to assess their ability to detect and draw inferences about facial age. Children were asked to select from sets of three faces the one that appeared youthful or to select faces that would be associated with some age-related characteristic. In two studies, it was found that, relative to other children, autistic children had more difficulty perceiving youthfulness in nonhuman faces compared with human faces. These data are discussed with respect to differences in mechanisms and processes that may underlie facial information processing in autistic and nonautistic children.     

Laboratory predictions of infantile autism based on 5-hydroxytryptamine efflux from blood platelets and their correlation with the rimland E-2 score

Experiments were conducted to determine the possibility of predicting a diagnosis of autism on the basis of an abnormally high release of¹⁴C-5-hydroxy-tryptamine from 5-HT loaded blood platelets of children. Such increased 5-HT release was previously reported by the authors for blood platelets of children diagnosed as autistic according to the Rimland E-2 score. The platelets of 10 psychotic children (including a number of subjects diagnosed as autistic by the E-2 score) were examined without knowledge of the diagnosis, in order to determine whether the biochemical results correlated with the E-2 score. On the basis of experimental data it was possible to predict that six children were autistic and four were nonautistic psychotics. According to the E-2 score, seven children were autistic and three nonautistic psychotics. The authors conclude that there is a correlation between a diagnosis of infantile autism by the E-2 score and enhanced release of radioactive 5-HT from 5-HT-loaded blood plateletsin vitro.This research was supported in part by National Institutes of Health Grant RR 00 284 and National Institute of Mental Health Grant HD 08429.     

Comparisons between autistic and nonautistic children on the Test for Auditory Comprehension of Language

Expressive language differences between autistic and nonautistic populations have been a topic of research in the past decade, yet little information is available in regard to the receptive language performances based on standardized tests. Questions as to the existence of sex differences in language have also been raised. The study examines the performance of 19 matched pairs of autistic and nonautistic children on the Test for Auditory Comprehension of Language. As well, the data were analyzed according to sex for each group. The results indicated that there were no significant differences between groups or between the sexes in either group. Questions for further research are raised.     

Sensitivity and specificity of the Behavioral Summarized Evaluation (BSE) for the assessment of autistic behaviors

The Behavior Summarized Evaluation (BSE), developed for the assessment of autistic behavior, was specifically designed to evaluate the severity of behavioral problems in autistic children involved in bioclinical and therapeutic studies. The reliability studies and the factorial analysis of this scale have been previously published. The present paper examines the effectiveness of the BSE to discriminate 58 autistic from 58 nonautistic mentally retarded children. The BSE clearly separated the two samples of children. A most efficient combination of 8 items emerged from the stepwise item selection procedure. The between-group differences were highest on 4 items, indicating that the most particular pattern in autistic compared to nonautistic children could be the association of autistic withdrawal and stereotypic behaviors. Our findings suggest that the BSE could help in the detection and evaluation of autistic developmental deviance. Implications for further research are discussed.The authors gratefully acknowledge Jacques Fermanian for his helpful advice and suggestions. This study was supported by INSERM U.316, INSERM Réseau No. 489001, CRAMTS No. 998313, Conseil Régional de la Région Centre, and Foundation Langlois. Special thanks to Monique Barré, Annick Lardeux, and Danièle Lioret for their technical assistance.     

Comparison and item analysis of the MESSY for autistic and normal children

Seventeen autistic children were matched for age, race, and sex with 17 nonautistic children, and group differences in social skills were assessed. Appropriate social skills and levels of inappropriate assertiveness/impulsiveness were assessed and evaluated using the Matson Evaluation of Social Skills with Youngsters (MESSY). Significant differences in both the appropriate and inappropriate social behaviors displayed by the two groups were found. The implications of these results are discussed.     

Gender Identity in Autism: Sex Differences in Social Affiliation with Gender Groups

High rates of gender variance have been reported in autistic people, with higher variance in autistic females than males. The social component of gender identity may be affected, with autistic females experiencing lower identification with and feeling less positively about their gender groups than controls. We measured gender identification, gender self-esteem, and aspects of gender expression (masculinity and femininity) in autistic natal males and females, and controls (N?=?486). We found that autistic people had lower gender identification and gender self-esteem than controls, and autistic natal females had lower gender identification than autistic natal males and natal female controls. In conclusion, autistic people, particularly natal females, had lower social identification with and more negative feelings about a gender group.     

Patterns of emotional and behavioural disturbance associated with autistic traits in young people with severe intellectual disabilities and challenging behaviours

Emotional and behavioural disturbance was assessed in 82 individuals with severe intellectual disabilities and challenging behaviour using the Diagnostic Assessment for the Severely Handicapped-II (DASH-II). Levels of disturbance were compared firstly in individuals with and without features of autism as assessed by the DASH-II, and secondly in individuals with varying severities of autism. In both cases levels of ability and overall severity of behaviour disorder were comparable across groups. Individuals with autistic features were found to have significantly higher scores than nonautistic individuals on the DASH-II organic disorder, anxiety, mania, PDD/autism and stereotypies subscales. When participants with autistic features were separated into groups of severe and moderate autism and compared with nonautistic participants, significant effects of group were found for scores on the anxiety, mood, mania, PDD/autism, schizophrenia and stereotypies subscales. Scheffé tests were conducted to further evaluate between-group differences. Item analysis showed seven DASH-II items to have a 30% or more difference between levels of endorsement in autistic and nonautistic individuals, with six further items showing a 20% or greater difference in levels of endorsement. Findings are compared to those from previous research and implications for the conceptualisation of emotional and behavioural disorders in individuals with autism are discussed.     

Autism and head circumference in the first year of life.

BACKGROUND: It has been reported that children with autism and pervasive developmental disorder have a significantly smaller head circumference at birth and that their head circumference then increases disproportionately rapidly in the first year of life. METHODS: We attempted to replicate these findings using 15 narrowly defined autistic children from the National Collaborative Perinatal Project and approximately 40,000 nonautistic control subjects. RESULTS: The autistic group had a slightly but not significantly larger head circumference at birth. At 4 months, the head circumference in the autistic group was not significantly larger than that of control subjects, but body weight and length were significantly larger in the autistic group. CONCLUSIONS: We believe this is the first report of significant general body growth in autistic children in infancy; the larger head circumference may be part of this excessive general growth.     

An examination of social typologies in autism

A system proposed by Wing and coworkers for subtyping autistic individuals on the basis of social interaction is examined in 78 autistic, 39 atypical, and 32 nonautistic, developmentally disordered individuals. Clinical ratings and questionnaire data based on the proposed subtypology were employed. Clinicians were able to reliably group both autistic and nonautistic cases into the three subtypes; these subtypes were strongly related to IQ. Issues relating to the validity and utility of this subtypology are discussed.     

Uptake and efflux of serotonin from platelets of autistic and nonautistic children

This study examined, in vitro, the uptake and efflux of serotonin by platelets from autistic children, nonautistic hospitalized comparison cases, and normal children. The autistic patients were carefully selected according to previously established diagnostic criteria. The hospitalized comparison children were utilized to assess possible environmental and dietary influences upon the results. Uptake methods were similar to those used by previous investigators. Two efflux procedures were utilized to explore the possibility that methodological factors accounted for previously reported differences between autistic and comparison groups. The results failed to indicate statistically significant differences in uptake or efflux between the autistic and the hospitalized comparison groups or the normals. Methodologic considerations which could possibly account for the failure to confirm previous findings are discussed in detail.     

Temporal lobe dysfunction in childhood autism: a PET study. Positron emission tomography

OBJECTIVE: The nature of the underlying brain dysfunction of childhood autism, a life-long severe developmental disorder, is not well understood. Although researchers using functional brain imaging have attempted to contribute to this debate, previous studies have failed to report consistent localized neocortical brain dysfunction. The authors reasoned that early methods may have been insensitive to such dysfunction, which may now be detectable with improved technology. METHOD: To test this hypothesis, regional cerebral blood flow was measured with positron emission tomography (PET) in 21 children with primary autism and in 10 nonautistic children with idiopathic mental retardation. Autistic and comparison groups were similar in average age and developmental quotients. The authors first searched for focal brain dysfunction in the autistic group by using a voxel-based whole brain analysis and then assessed the sensitivity of the method to detect the abnormality in individual children. An extension study was then performed in an additional group of 12 autistic children. RESULTS: The first autistic group had a highly significant hypoperfusion in both temporal lobes centered in associative auditory and adjacent multimodal cortex, which was detected in 76% of autistic children. Virtually identical results were found in the second autistic group in the extension study. CONCLUSIONS: PET and voxel-based image analysis revealed a localized dysfunction of the temporal lobes in school-aged children with idiopathic autism. Further studies will clarify the relationships between these temporal abnormalities and the perceptive, cognitive, and emotional developmental abnormalities characteristic of this disorder.