Brief Report: Pervasive Developmental Disorder Can Evolve into ADHD: Case Illustrations

Despite prominent attentional symptoms in Pervasive Developmental Disorders (PDD) the relationship between PDD and Attention Deficit Hyperactivity Disorder (ADHD) has received little direct examination. In addition, outcome studies of children with PDD often focus on language, educational placement, or adaptive skills, but seldom on loss of the PDD diagnosis or change to another clinical syndrome. We present three cases in detail, and tabular data on eight more, that illustrate a clinical presentation in which prototypical cases of PDD evolve into clear-cut cases of ADHD from early to middle childhood.     

Brief Report: Prevalence of Pervasive Developmental Disorder in Brazil: A Pilot Study

This pilot study presents preliminary results concerning the prevalence of Pervasive Developmental Disorder (PDD) in South America. It was a three-phase study conducted in a typical town in Southeast Brazil. Case definition was based in a combination of standardized instruments and clinical evaluations by experts. The prevalence of PDD was 27.2/10,000 (95% CI: 17.6–36.8) and some hypotheses were raised to explain this low frequency. Clinical findings of PDD cases were consistent with previous data, such as, male preponderance, more children diagnosed with PDD-NOS than with autistic disorder, and half of them born from older mothers. Moreover, the study raised concerns about treatment of cases, because identification of PDD had been late and access to services has been very limited.     

Brief Report: Parental Reporting of Regression in Children with Pervasive Developmental Disorders

Information on age and nature of the onset of autism and other developmental disorders was obtained through review of parent completed developmental history; in addition information on the childs early development, diagnostic information, and information on parent characteristics was also obtained. In this relatively large series of cases the parents of children with autism were more likely than parents of children with other developmental disorders to report possible loss of developmental skills. However, the question of actual skill loss was complicated since in some cases parents also had reported even earlier developmental delays or a pattern more of developmental stagnation than clear loss of abilities. Only a few children exhibited a clear and unequivocal loss of developmental skills.     

Pseudologia Fantastica associated with Pervasive Developmental Disorder

This case study describes the association of Pseudologia Fantastica (PF) and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) in a 14-year-old girl. PF is seen in a number of diagnostic entities, but has not previously been reported in PDD spectrum disorders. Treatment implications are discussed along with a formulation of the psychological and cognitive functions of PF in a person with a PDD diagnosis.     

ADHD Symptom Subtypes in Children with Pervasive Developmental Disorder

Objective Compares DSM-IV ADHD subtypes in large samples of 3-to-5 and 6-to-12 year old children with pervasive developmental disorder (PDD) vs. nonPDD clinic referrals.Method Parents and teachers completed a DSM-IV-referenced rating scale.Results ADHD subtypes were clearly differentiated from the nonADHD group and showed a differential pattern of co-occurring psychiatric symptoms (more pronounced for teacher- than parent-defined subtypes and older than younger children) that was similar in both PDD and nonPDD samples. The Combined type had more severe oppositional, aggressive, and PDD symptoms than Inattentive type and were from less advantaged homes than other subtypes. Hyperactive-Impulsive type was least impaired.Conclusion Findings support the notion that ADHD may be a clinically meaningful syndrome in children with PDD.     

Fragmented Visuospatial Processing in Children with Pervasive Developmental Disorder

Children diagnosed with Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) and Asperger Syndrome (AS) may be characterised by a similar perceptual focus on details as children with autistic disorder (AD). This was tested by analysing their performance in a visuoperceptual task [the Children’s Embedded Figure Test (CEFT)] and a graphic reproduction task [the Rey Complex Figure Task (Rey CFT)]. Control groups were children with Tourette Syndrome (TS) and typically developing children. The TS sample performed similarly to the normal control group in both tasks. The CEFT results did not show the expected preference for local processing in children with PDD-NOS. However, the Rey CFT data revealed that the children with this lesser variant of PDD processed visuospatial information in a fragmented way and were deficient in global processing.     

Diagnostic utility of the Pervasive Developmental Disorder Behavior Inventory

This study assessed the diagnostic utility of the Pervasive Developmental Disorder Behavior Inventory (PDDBI) in a sample of 84 children aged 3-12 years of age. Forty-two children with ASD were individually matched on age and non-verbal IQ to 42 children with other disabilities and groups were compared on PDDBI subscales and total score. Results indicated that the groups differed on the total score and on only one of the 14 subscales. Optimal sensitivity and specificity were achieved using a cutoff score of 45 on the Autism Composite T-score. Diagnostic accuracy was not good (sensitivity = .74, specificity = .62, efficiency = .68), but better in individuals with NVIQ < 70. We do not recommend the PDDBI for diagnostic screening.     

Skill acquisition in students with and without Pervasive Developmental Disorder

The purposes of this study were (a) to examine skill acquisition in field hockey of seven junior-high school students with PDD, who attended an inclusive class; and (b) to compare the degree of skill acquisition in field hockey of junior-high school students without disabilities who attend an inclusive class and those who attend a regular class.The motor performance of the students with and without PDD was compared using specially designed field hockey skill tests, before and after a skill acquisition period of two 45-min sessions. Results indicated that (a) students with PDD significantly increased motor performance in the cone circling (CC) task (p < .002); and (b) the percentage gain score of students without disability in the regular class was significantly better in the CC task (p < .02) compared to that in the inclusive class, but did not differ in the slalom between cones task.     

Strategies for Perceiving Facial Expressions in Adults with Autism Spectrum Disorder

Rutherford and McIntosh (J Autism Dev Disord 37:187–196, 2007) demonstrated that individuals with autism spectrum disorder (ASD) are more tolerant than controls of exaggerated schematic facial expressions, suggesting that they may use an alternative strategy when processing emotional expressions. The current study was designed to test this finding using photographs of real people. In addition, two control tasks were added to eliminate alternative explanations. We replicated the findings of Rutherford and McIntosh (J Autism Dev Disord 37:187–196, 2007) and also demonstrated that adults with ASD do not show this tolerance when evaluating how realistic the expressions are. These results suggest adults with ASD employ a rule-based strategy to a greater extent than typical adults when processing facial expressions but not when processing other aspects of faces.     

Larger Brains in Medication Naive High-Functioning Subjects with Pervasive Developmental Disorder

Background: Are brain volumes of individuals with Pervasive Developmental Disorder (PDD) still enlarged in adolescence and adulthood, and if so, is this enlargement confined to the gray and/or the white matter and is it global or more prominent in specific brain regions. Methods: Brain MRI scans were made of 21 adolescents with PDD and 21 closely matched controls. Results: All brain volumes, except the white matter, were significantly larger in patients. After correction for brain volume, ventricular volumes remained significantly larger in patients. Conclusions: Patients showed a proportional, global increase in gray matter and cerebellum volume, and a disproportional increase in ventricular volumes. Thus, at least in high-functioning patients with PDD, brain enlargement may still be present in adult life.     

Injury Treatment among Children with Autism or Pervasive Developmental Disorder

This study examined the differences in the frequency and type of injury for children with autism and pervasive developmental disorder (PDD) compared with typically developing peers, when both groups are insured by Medicaid. The relative rate (RR) of emergency/hospital treatment of injury for children with autism or PDD compared to controls was 1.20 [95% Confidence Interval (CI) 1.04–1.39] after controlling for age and gender. Children with autism or PDD had a higher rate for head, face, and neck injuries (RR 1.47, 95% CI 1.13–1.90) and lower rate for sprains and strains (RR 0.54, 95% CI 0.32–0.91). Treatment for poisoning was 7.6 times as frequent, and self-inflicted injury was also 7.6 times as frequent for children with autism or PDD.     

Atypical processing of fearful face-voice pairs in Pervasive Developmental Disorder: an ERP study

OBJECTIVE: An important premise for successful social-affective communication is rapid perception of visual and auditory emotional cues, as well as their multisensory integration (MSI). We investigated to what extent a deficit in recognition of emotions in individuals with Pervasive Developmental Disorder (PDD) may have its roots in abnormal MSI of emotional cues provided by the sight of a facial expression and an emotional tone of voice. METHODS: In twelve high-functioning, adult PDD individuals and thirteen age- and IQ-matched controls, (1) the processing of fearful faces was compared with that of happy faces; (2) MSI was assessed by characterizing the interaction effects of crossmodal presentation, using EEG. RESULTS: Increased P1 and N170 amplitudes were seen in response to fearful faces compared with happy faces in both groups. However, PDD individuals differed from healthy controls in MSI of fearful information from visual and auditory cues. CONCLUSIONS: Both groups show a similar pattern as concerns the early components of visual emotion processing, but there are anomalies in processing of fearful face-voice combinations in the PDD group. SIGNIFICANCE: Because of the importance of rapid MSI for social competence, MSI anomalies in PDD may be linked to the observed deficits in their emotional behavior.     

ERPs and Eye Movements Reflect Atypical Visual Perception in Pervasive Developmental Disorder

Many studies of eye tracking or event-related brain potentials (ERPs) in subjects with Pervasive Developmental Disorder (PDD) have yielded inconsistent results on attentional processing. However, recent studies have indicated that there are specific abnormalities in early processing that are probably related to perception. ERP amplitudes in response to visual stimuli, measured above the occipital (modality-specific) cortex, are reported to be abnormally small in patients with PDD, and the abnormal visual processing is possibly associated with the spatial visual frequency content of stimuli. It is suggested that subjects with PDD show abnormal activation of visual pathways dedicated to the processing of high and low spatial frequencies.