Brief report: pitocin induction in autistic and nonautistic individuals

Oxytocin plays an important role in social-affiliative behaviors. It has been proposed that exposure to high levels of exogenous oxytocin at birth, via pitocin induction of delivery, might increase susceptibility to autism by causing a downregulation of oxytocin receptors in the developing brain. This study examined the rates of labor induction using pitocin in children with autism and matched controls with either typical development or mental retardation. Birth histories of 41 boys meeting the criteria for autistic disorder were compared to 25 age- and IQ-matched boys without autism (15 typically developing and 10 with mental retardation). There were no differences in pitocin induction rates as a function of either diagnostic group (autism vs. control) or IQ level (average vs. subaverage range), failing to support an association between exogenous exposure to oxytocin and neurodevelopmental abnormalities.     

Adaptive and intellectual functioning in autistic and nonautistic retarded children

This study examined the relationship between adaptive functioning on the Vineland Adaptive Behavior Scale (VABS) and intellectual functioning on the Stanford-Binet Intelligence Scale, 4th edition (SB-IV) in autistic children and nonautistic retarded children of comparable CA and SB-IV composite score (IQ). The autistic group had lower scores than the retarded group in VABS adaptive composite, Socialization domain, and Communication domain, and SB-IV Verbal Reasoning area. VABS domain scores yielded higher classification rates than the SB-IV area scores in discriminating the two groups. Correlations between the two measures were much higher for the autistic group than for the retarded group. Results support the conclusion that the cognitive impairment in autism is reflected in greater impairment in adaptive behaviors than in mental retardation without autism.This project was partially supported by a Center of Excellence grant from the State of Tennessee to the Department of Psychology, The University of Memphis. Appreciation is extended to the University of Tennessee Boling Center for Developmental Disabilities and to the children and parents who participated in this study.     

Brief report: A comparison of patterns of cognitive functioning of autistic and nonautistic retarded children on the stanford-binet-fourth edition

This research was supported in part by a Center of Excellence grant from the State of Tennessee to the Department of Psychology, Memphis State University. We thank Michael Lupfer and Charles Long for their contributions to this article. Appreciation is also extended to Cynthia Devine, Suzanne Dix, and Farhana Shah for their help in data collection and to the Memphis Autism Society, Sister Ruth Ann of Madonna Day School, Gerald Golden, Manual Soto Viera, Charles Portis, and Ruth White of the University of Tennessee Boling Center for Developmental Disorders for their assistance in this project. Finally, we offer special thanks to the children and parents who participated in the study.     

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.     

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.     

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.     

Development and evaluation of a psychoeducational parent group training program for families with autistic children

In the introduction of this study, the concept of "psychoeducational parent training" is analyzed, and an outline of the research literature on "parent training in families with autistic children" is presented. Based on these findings a psychoeducational group parent training, which focused on (1) addressing issues of nature, etiology, treatment and family-related consequences of autism (2) teaching child management and education skills was developed, and the training outcomes were evaluated within a 3-months-follow-up design. A total of 24 parents of 23 autistic children (mean age: 9 yrs.) participated in the center-based training program which was performed in three small groups in different areas of Germany in 3 one-day sessions succeeding in 1-month-intervals. The outcome variables included: (a) group training assessments by parents; they evaluated quality of trainer variables, curriculum, and group atmosphere using a questionnaire format of bipolar rating scale-items (b) parental 3-months-follow-up assessments of the effects of group training on parent-child interactions and family adaptation, using a questionnaire based on rating scales, and a semi-structured questionnaire on training-related child and parent behaviors in the family. The parent training resulted in (a) a high degree of parent satisfaction with the training format and (b) positive effects on daily parent-child interactions from the perspective of parents. These findings provide some evidence for both clinical and social validity of the parent training procedure examined in this study.     

A comparison of parent-reported fear for autistic and nonhandicapped age-matched children and youth

Fourteen autistic children and youth matched with nonhandicapped same age, same sex peers ranging in age from 2 1/2 to 17 years of age were rated by their parents on the Revised Fear Survey Schedule for Children. Percent of autistic children rated as having specific common fears (i.e., “fears of the unknown”) was higher for autistic than the non-handicapped children. Further, some fears were quite different. Thunderstorms, getting punished by father, dark places, being in a big crowd, going to bed in the dark, closed places, and going to the dentist were in the top 10 fears for autistic children but not for the non-handicapped persons. Such differences suggest either qualitative variations or developmental differences between these groups. Similar in scope to the fears of younger normal children, loud sounds, dark places and strangers were rated as producing more fear in autistic persons. The implications of these data are discussed.     

A comparison between the Handicaps Behaviour and Skills Schedule and the psychoeducational profile

Comparisons were made of developmental scores (administered with the Psychoeducational Profile [PEP] and the Handicaps Behaviour and Skills Schedule [HBS] for a group of 72 children ages 23 to 148 months. All children had been referred to the Centre of Autism in Leiden, the Netherlands. This Centre is a collaboration between the University clinic of special education and the regional health service. Forty-five children were diagnosed as autistic and 27 as nonautistic but suffering from another disorder. In this study, the correlation between the two instruments is higher than expected, in particular for the group of autistic children (.83). The internal consistency of the subscales of the PEP and the HBS are overall very satisfactory. The Cronbach's alphas of the PEP scales vary from .79 to .96 for the total group and from .77 to .95 for the autistic group. The alphas for the HBS vary from .74 to .92 for the total group and from .20 to .87 for the autistic group, there is one alpha at .20, the rest are .60 or higher.     

A comparison study of autism spectrum disorder referrals 1997 and 1989

A number of overseas studies have indicated an increase in the prevalence of Autism Spectrum Disorder (ASD). In the Australian Capital Territory, information (number, age, sex, final diagnosis) was gathered on all children referred for suspected ASD to Child and Adolescent Mental Health Service during 1997, and the findings were compared with those from a similar study in 1989. It was found that (1) there was a 200% increase in positive diagnoses of ASD in 1997 despite a 0.5% decrease in population, (2) there was a wider age range in the 1997 cohort, (3) there was a 26% increase in milder cases in 1997, and (4) the ratio of boys to girls decreased from 8:1 in 1989 to 3.5:1 in 1997. These findings are compared with those overseas, and questions are raised for further exploration.     

A comparison of autistic syndromes with and without associated neurological problems

Conclusions The findings show that autistic syndromes with and without associated neurological deficits are remarkably similar in terms of severity and type of autistic symptoms, IQ, and sex distribution. Children with an associated neurological disorder tended to have had autistic features from birth, but this may have been an artifact resulting from the closer clinical observation that many would have received because of their medical problems. Findings from related studies have also shown that autistic syndromes with and without neurological deficits do not differ with respect to urinary homovanillic acid levels (Garreau et al., 1980), dihydroxy-phenylacetic acid levels (Landgrebe & Landgrebe, 1976), auditory evoked potentials (Martineau, Garreau, Barthelemy, Callaway, & LeLord, 1981) or response to vitamin B₆ administration (LeLord et al., 1981; Martineau et al., 1981). This research was supported by CNRS (ERA N-697) “Biology and Neuropsychiatry,” INSERM 650.34 and Social Security 1982. We wish to thank Mrs. Barre, Mrs. Lardeux, and Mrs. Crespin for their technical work.     

A comparison of personality variables in autistic and mentally retarded children

Personality characteristics of 35 severely mentally retarded children, including 11 with Down's Syndrome, and 32 autistic children evaluated on the basis of the Behavior Rating Instrument for Autistic Children are compared and discussed. The children, 48 boys and 19 girls, ranged in age from 4 to 12 years. Rating on five scales pertaining to nature and degree of relationship to an adult as a person, communication, vocalization and expressive speech, drive for mastery, and psychosexual development, all described in some detail, indicated that the severely retarded group scored significantly higher in each area. Also higher for that group were the correlations between various scales. It is suggested that severely retarded children, particularly those with Down's Syndrome, are less disturbed, and better integrated than autistic and that fragmentation, compartmentalization and lack of generalization between key areas of function are specific factors in the autistic process.This study was supported in part by National Institute of Mental Health Grant MH-00982.     

Characterization and comparison of autistic subgroups: 10 years' experience with autistic children

To summarize our 10-year experience with autistic children at the Tel Aviv Child Development Center, the files of all 55 children with autism treated at our center over a 10-year period were retrospectively reviewed. Particular attention was addressed to the value of the medical work-up in detecting the etiology of autism and to factors differentiating infantile autism (IA) from autistic-like behavior (ALB). Twenty-four subjects (44%) had IA and 31 (56%) had ALB. These subgroups were compared for demographic, perinatal, familial, neurological, and psychological findings, and outcome at discharge. Associated medical conditions and the yield of metabolic work-up and neuroimaging and electroencephalography studies are discussed. The two subgroups differed only in severity of autistic symptoms and cognitive function (P<0.05), but not in demographic or neurobiological findings. It was concluded that IA and ALB are similar conditions, and autism has a wide continuum of clinical expressions.     

The presence or absence of certain behaviors associated with infantile autism in severely retarded autistic and nonautistic retarded children and very young normal children

The modified Behavior Observation Scale adapted from Freeman et al. was used to compare normal, retarded, and autistic children with very low developmental ages and to determine the types of behavior that could differentiate these three diagnostic categories of children. Examination of the data revealed that there was much more overlap between autistic and retarded children than between autistic and normal children. However, a behavioral pattern of autism could be delineated and very retarded autistic children could be distinguished from the nonautistic retarded children. The autistic behavioral pattern included subclusters of symptoms that might be interpreted as disturbances of sensory modulation and motility.This study was supported by C.N.R.S. (UA596), Biology and Neuropsychiatry, Sécurité Sociale 1982, and Fondation Langlois. We thank B. Baron, E. Vaudelon, J. Beurier-Charriere, P. Colombel, S. Roux, D. Lioret, and J. Sapede for their assistance.     

Behavioral therapy for treatment of stereotypic movements in nonautistic children

Although typically described in autistic, mentally retarded, and sensory-deprived individuals, motor stereotypies also occur in normal children. In this preliminary report, the behavior modification techniques of habit reversal and differential reinforcement of other behavior were evaluated as a therapeutic modality for the suppression of stereotypic movements in nonautistic subjects. Twelve children, ages 6 to 14 years, with physiologic stereotypies were treated using a standardized treatment protocol. Clinical outcomes were based on differences between assessments obtained at baseline and on telephone follow-up. Evaluation scales included measures of the frequency, intensity, interference, and number of stereotypies (Stereotypy Severity Scale motor portion and Stereotypy Linear Analog Scale) and assessment of global function (Child Global Assessment Scale and Stereotypy Severity Scale global portion). The results were correlated with the child's level of motivation and the number of treatment sessions. After a mean follow-up of 12.1 months, motor stereotypies showed significant improvement on the Stereotypy Linear Analog Scale and Stereotypy Severity Scale total score, P = .009 and P = .046, respectively. Both scales showed a relationship between the number of treatment sessions attended and a reduction in movements. The Child Global Assessment Scale also improved with therapy, but there was no correlation with the number of treatment sessions. Highly motivated patients had greater improvement on the Stereotypy Linear Analog Scale and Stereotypy Severity Scale scales compared with less motivated patients, but motivation had no impact on the Child Global Assessment Scale. The combined use of habit reversal and differential reinforcement of other behavior is beneficial in reducing motor stereotypies in nonautistic children.     

A comparison of obstetric and neonatal complications between children with autistic disorder and their siblings

Sixty-one children had a diagnosis of autistic disorder according to the DSM3-R criteria in a population based study of mentally retarded children between the ages of 5 and 19 years in the Aberdeen city area of Scotland. Obstetric case records were traced for 36 out of these 61 autistic children. The obstetric case records of siblings of 30 of these autistic children were also traced. Modified versions of Prechtl's obstetric optimality scale along with that of Pamas were used to score pre-, peri-and neonatal obsteric complications in the autistic group and their normal sibling controls. A Spearman's correlation coefficient test between the scores of the Childhood Autism Rating Scale (CARS) and the Obstetric and Neonatal Complication (ONC) scores of all autistic children did not reveal any significant correlation. However, among the 20 severe autistic children, Spearman's test showed significant correlation between the scores of CARS and some ONC scores. Overall, no statistically significant difference between the autistic children and their siblings in the scores of obstetric optimality was detected by using the Wilcoxon test.     

Generating referrals to newly established programs: A cost effective comparison of two procedures

This study compares the relative effectiveness of two approaches to generating referrals to a newly established program for families with aggressive children. The approaches, an inservice with follow-up contact and an inservice without follow-up contact, were applied to two matched groups of schools. The results indicated that the inservice plus follow-up contact group referred 4 times as many families (significant p<.025 one-tailed). These results suggest that the inservice plus follow-up procedure was (1) more cost effective than the inservice procedure alone in generating referrals, (2) allowed a prescreening opportunity and (3) allowed an individualized public relations contact.Special appreciation is extended to Charles McCarthy and the Youth Development Bureau staff, Montana Social and Rehabilitation Services; Steve Nelson and the Montana Board of Crime Control; The Family Teaching Center Board of Directors, past presidents Cheryl Gillespie, Arvin Jackson, Margaret Stuart, Joe Mazurek, and Joy McGrath; and the Family Teaching Center staff, Sherri Burtch, Darlene Durgan, Marilyn Hamerlynck, Brenda Lillie, Eileen Morgan, Dale Parsons, and Donna Wood for making this study possible. Partial support for this research was also provided by the Center for Studies of Crime and Delinquency, NIMH (grant #MH25548 and MH29786). Family Research Associates is an affiliate of the Wright Institute, Berkeley, California.