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.     

A pair of classically early infantile autistic siblings

This case study describes in detail two autistic siblings who were mentioned in Rimland's analysis of checklists for psychotic children, as the only pair of classically early infantile autistic siblings (Rimland, 1971). One of the children, a nonverbal girl, now 13 years old, who developed epileptic seizures at age 4 1/2, shows all symptoms of early infantile autism even today. Her brother, now 24 years old, however, does not fit any of the known psychopathological patterns of childhood. The boy showed all symptoms of early infantile autism, but also some of the main characteristics of childhood schizophrenia and autistic psychopathy. It is suggested that we are dealing perhaps with an unusual mixed type falling within a broad category of genetically determined types of autistic disorders.     

Behavioral relationship between autism and fragile x syndrome

Previous researchers have reported autistic features in children with fragile X syndrome. We compared 21 children with pervasive developmental disorders (autism group) to 15 with fragile X syndrome on the Childhood Autism Rating Scale and the Reiss Scales for Children's Dual Diagnosis. The 7 children (47%) with fragile X who scored above the Childhood Autism Rating Scale cut-off (fragile X-autism group) were more impaired than the remaining children (fragile X-no autism) on Childhood Autism Rating Scale subscales related to emotion, visual and listening responses, and communication. The autism group's Reiss scores were higher than fragile X-no autism group, but not fragile X-autism group. Although the Childhood Autism Rating Scale identified almost 50% of children with fragile X as having autism, qualitative differences may exist in specific autistic-like behaviors between children with autism and children with fragile X.     

A closer look at the Autism Behavior Checklist: Discriminant validity and factor structure

The psychometric properties of the Autism Behavior Checklist (ABC; Krug, Arick, & Almond, 1980a, 1980b), a 57-item screening checklist for autism was investigated. Professional Informants completed the ABC on 67 autistic and 56 mentally retarded and learning-disabled children. The autistic children were the total population of autistic children aged 6–15 in two circumscribed suburban and rural regions. Using the total score, the ABC accurately discriminated 91% of the children, with 87% of the autistic and 96% of the nonautistic group correctly classified. Moreover, the accuracy of classification was virtually identical when only the more heavily weighted checklist items were used. A 3-factor model accounted for 32% of the total variance in the checklist. Seventeen items loaded.4 or more on Factor 1, 12 items loaded on Factor 2, and 10 items loaded on Factor 3. The present results fail to provide empirical support for a single unidimensional scale for autism. Also, there is little support for subdividing the checklist into five subscales based on symptom areas.This research was supported by grant No. 6603-1202-42 from the National Health Research and Development Program of Health and Welfare Canada to the second author and a Social Sciences and Humanities Research Council of Canada Doctoral Fellowship to the first author. We thank all of the parents and children who have contributed to this research. We also thank Isabel Smith, Julia McInnes, Margaret MacKinnon Doncaster, Mary Clark-Touesnard, Leslie Donovan, and Penny Corkum for data collection.     

A comparison and evaluation of three commonly used autism scales

Reliability and validity of three commonly used autism scales, the Autism Behavior Checklist (Krug, Arick, & Almond, 1980), the Real Life Rating Scale (Freeman, Ritvo, Yokota, & Ritvo, 1986), and the Childhood Autism Rating Scale (Schopler, Reichler, & Renner, 1988), were investigated. Data analyses were based on completed protocols for 24 children or adolescents who met DSM-III-R criteria for pervasive developmental disorders. First, to replicate previous findings, interrater reliability of each of the two direct observational scales was assessed. Second, correlations between pairs of the three scales were calculated. Third, diagnostic classifications based on autism scale cutoff scores were compared to classifications based on DSM-III-R criteria. Fourth, relationships between autism scale scores and adaptive behavior scores were investigated. Results and implications for the use of these scales in the assessment of autistic behaviors are discussed.Special thanks to John Junginger for his help and support throughout this project.     

Increased serum osteopontin levels in autistic children: relation to the disease severity

Autoimmunity to brain may play an etiopathogenic role in autism. Osteopontin is a pro-inflammatory cytokine that has been shown to play an important role in various autoimmune neuroinflammatory diseases. Osteopontin induces IL-17 production by T-helper 17 lymphocytes, the key players in the pathogenesis of autoimmune disorders. Anti-osteopontin treatment reduces the clinical severity of some autoimmune neuroinflammatory diseases by reducing IL-17 production. We are the first to measure serum osteopontin levels, by ELISA, in 42 autistic children in comparison to 42 healthy-matched children. The relationship between serum osteopontin levels and the severity of autism, which was assessed by using the Childhood Autism Rating Scale (CARS), was also studied. Autistic children had significantly higher serum osteopontin levels than healthy controls (P < 0.001). Increased serum osteopontin levels were found in 80.95% (34/42) of autistic children. Children with severe autism had significantly higher serum osteopontin levels than patients with mild to moderate autism (P = 0.02). Moreover, serum osteopontin levels of autistic patients had significant positive correlations with CARS (P = 0.007). In conclusions, serum osteopontin levels were increased in many autistic children and they were significantly correlated to the severity of autism. Further wide-scale studies are warranted to shed light on the etiopathogenic role of osteopontin in autism and to investigate its relation to IL-17 and brain-specific auto-antibodies, which are indicators of autoimmunity, in these patients. The therapeutic role of anti-osteopontin antibodies in amelioration of autistic manifestations should also be studied.     

Siblings and Autism: Stories Spanning Generations

A review was conducted for ‘D.L. Cumberland and B.R. Mills (Eds), Siblings and Autism: Stories spanning generations and cultures. Philadelphia, Jessica Kingsley Publishers, 2011, 239 pp., ISBN 978-1-84905-831-5, $18.95 (paper)’. In comparison with similar literature on families and their perspectives on a family member being diagnosed with autism and/or growing up autistic, Cumberland and Mills (Siblings and Autism: stories spanning generations and cultures. Jessica Kingsley Publishers, Philadelphia, USA, 2011) editing positions the writers as a previously poorly accessed population; the siblings of children with autism. Narratives from those siblings, now in their adulthood, give a rare insight on the variability of the disorder’s development and outcomes for the individual and the family.     

Autism and diagnostic substitution: evidence from a study of adults with a history of developmental language disorder

Rates of diagnosis of autism have risen since 1980, raising the question of whether some children who previously had other diagnoses are now being diagnosed with autism. We applied contemporary diagnostic criteria for autism to adults with a history of developmental language disorder, to discover whether diagnostic substitution has taken place. A total of 38 adults (aged 15–31y; 31 males, seven females) who had participated in studies of developmental language disorder during childhood were given the Autism Diagnostic Observation Schedule - Generic. Their parents completed the Autism Diagnostic Interview - Revised, which relies largely on symptoms present at age 4 to 5 years to diagnose autism. Eight individuals met criteria for autism on both instruments, and a further four met criteria for milder forms of autistic spectrum disorder. Most individuals with autism had been identified with pragmatic impairments in childhood. Some children who would nowadays be diagnosed unambiguously with autistic disorder had been diagnosed with developmental language disorder in the past. This finding has implications for our understanding of the epidemiology of autism.     

Relationship of autistic traits between parents and children with and without autism spectrum disorder

BackgroundAlthough parents with a child with autism spectrum disorder (ASD) have usually been identified as having the “broader autism phenotype”, empirical research on the differences in autistic-like characteristics between parents with and without ASD children has yielded inconsistent results.MethodThis survey of the autistic traits of parents and children was conducted in 119 parents with ASD children and 108 parents with typically developing (TD) children. Parents’ autistic traits were quantified using the Autism-Spectrum Quotient and children’s autistic traits were quantified using the Autism Spectrum Quotient—Children’s Version.ResultsThe autistic traits of ASD children were significantly higher than those of the TD children; however, autistic traits were similar between parents in the two groups. Furthermore, the correlations of autistic traits between parents and children were only significant for the TD group and not for the ASD group.ConclusionsThe current findings indicate that the relationship of autistic traits between parents and children exists in the TD group, and that the Autism-Spectrum Quotient may be used for parents as a screening aid to identify children who should be further screened for autistic traits.     

Children's Attitudes and Behavioral Intentions Toward a Peer with Autistic Behaviors: Does a Brief Educational Intervention Have an Effect?

This study examined children's ratings of attitudes and behavioral intentions toward a peer presented with or without autistic behaviors. The impact of information about autism on these ratings was investigated as well as age and gender effects. Third- and sixth-grade children (N = 233) were randomly assigned to view a video of the same boy in one of three conditions: No Autism, Autism, or Autism/Information. Children at both grade levels showed less positive attitudes toward the child in the two autism conditions. In rating their own behavioral intentions, children showed no differences between conditions. However, in attributing intentions to their classmates, older children and girls gave lower ratings to the child in the autism conditions. Information about autism did not affect ratings of either attitudes or behavioral intentions as ascribed to self or others.     

A validity analysis of selected instruments used to assess autism

Differentiating autism from other handicapping conditions, especially mental retardation, has been a constant problem for public schools. This study investigated the effectiveness of three instruments to discriminate autistic from trainable mentally retarded children. The Autism Screening Instrument for Educational Planning, the Childhood Autism Rating Scale, and the Diagnostic Checklist for Behavior Disturbed Children, Form E-2 were administered to 20 autistic and 20 TMR students. Discriminant analysis was used to determine the best linear combination of scores that would separate the two groups of children. All three instruments were found to separate the two samples of children. However, the CARS and the ASIEP provided for a greater separation of groups.Statistical support was provided by the Statistical Research Laboratory, Southern Methodist University, Dallas, Texas, 75275, Dovalee Dorsett, Ph.D., director.     

Autism Diagnostic Interview-Revised and the Childhood Autism Rating Scale: convergence and discrepancy in diagnosing autism

The agreement between the Autism Diagnostic Interview–Revised (ADI-R) and the Childhood Autism Rating Scale (CARS) was investigated in the diagnostic assessment of 54 children aged 22–114 months referred for possible autism. The observed agreement between the two systems was 66.7% (Cohen's kappa = .40) when the ADI-R definition for autism was applied (i.e., scores reaching cutoff in three domains on the ADI-R), but increased considerably with less stringent criteria; that is, scores reaching cutoffs in two domains and in one domain on the ADI-R. As predicted, the CARS identified more cases of autism than the ADI-R. Children classified as autistic according to both instruments had significantly lower IQ/DQ and more severe autistic symptomatology than those classified with the CARS only.     

Parental Report of Sleep Problems in Children with Autism

This research evaluated parent reports of sleep behaviors of four groups of children: those with Autism or Pervasive Developmental Disorders, those with General Mental Retardation alone, those attending Special Education classes (with no MR diagnosis), and a control group of similar aged children without a developmental diagnosis. Diagnostic classification and demographic information were determined through parent report, report of classroom registration, and the Gilliam Autism Rating Scale (Gilliam, 1995). To evaluate sleeping behavior the study used a 28-item, five-factor scale (Behavioral Evaluation of Disorders of Sleep/BEDS; Schreck, 1997/1998) constructed from the diagnostic criteria for childhood sleep disorders found in the International Classification of Sleep Disorders: Diagnostic and Coding Manual (ICSD, American Sleep Disorders Association, 1990). Findings suggest that reports of parents with children with autistic characteristics exhibit expected quantities of sleep, but parent perception of their sleep difficulties and sleep quality is different for children with autism than for children in all other study groups.     

A validation study of the Chinese version of the Autism Parenting Stress Index (C-APSI) in Hong Kong

BackgroundParents of children with Autism Spectrum Disorders are facing higher parenting distress than typical parents. Despite its economic prosperity, Hong Kong has only recently developed an early intervention service by the government for children with autism. Such a change provides an opportunity to develop better psychometric screening measuring parenting distress. Existing scales measuring parenting distress are often found to have high monetary and time costs, resulting in parent distress being neglected in treatment planning.MethodTo address this as well as language-based challenges, a Chinese version of an existing 13-item Autism Parenting Stress Index (C-APSI) was developed and validated in a Hong Kong clinical (n = 112) and control (n = 65) samples.ResultsThe translated version showed satisfactory test-retest reliabilities. Although the previously found factor structure could not be replicated, the scale’s internal consistency and test-retest reliability was satisfactory. Parenting distress did not correlate with objective measures of cognitive functioning, but it did with subjective reports of daily functioning of autistic children, age of parents and family income.ImplicationsThe current study bridges the gap for the need of a validated scale for screening or quick assessment for Hong Kong Chinese parents with autistic children. The marked difference in mean scores compared to the US sample suggests cultural differences in how parents perceive the distress arising from taking care of their children.     

Evaluating the Feasibility of The NIH Toolbox Cognition Battery for Autistic Children and Adolescents

Journal of Autism and Developmental Disorders - This study evaluates the feasibility of the NIH Toolbox Cognition Battery (NIH-TCB) for use in autism spectrum disorder (ASD). 116 autistic children...     

The Autism-Spectrum Quotient (AQ)—Adolescent Version

The Autism Spectrum Quotient (AQ) quantifies autistic traits in adults. This paper adapted the AQ for children (age 9.8–15.4 years). Three groups of participants were assessed: Group 1: n=52 adolescents with Asperger Syndrome (AS) or high-functioning autism (HFA); Group 2: n=79 adolescents with classic autism; and Group 3, n=50 controls. The adolescents with AS/HFA did not differ significantly from the adolescents with autism but both clinical groups scored higher than controls. Approximately 90% of the adolescents with AS/HFA and autism scored 30+, vs. none of the controls. Among the controls, boys scored higher than girls. The AQ can rapidly quantify where an adolescent is situated on the continuum from autism to normality.     

Plasma Oxytocin in Children with Autism and Its Correlations with Behavioral Parameters in Children and Parents

Objective

Oxytocin (OT) has been implicated to play an important role in autism spectrum disorders (ASD) etiology. We aimed to find out the differences in plasma OT levels between children with autism and healthy children, the associations of OT levels with particular autism symptoms and the associations of particular parental autistic traits with their ASD children OT levels.

Methods

We included 19 boys with autism and 44 healthy age-matched boys. OT levels were analyzed by ELISA method. Children with autism were scored by Childhood Autism Rating Scale and Autism Diagnostic Interview (ADI), adjusted research version. Autism Spectrum Quotient (AQ), Systemizing Quotient (SQ) and Empathizing Quotient were completed by parents of children with autism.

Results

Children with autism had significantly lower plasma OT levels than controls. OT levels positively correlated with ADI Reciprocal Interaction and Communication scores. AQ and SQ of fathers positively correlated with children plasma OT level.

Conclusion

Our results support the hypothesis of OT deficiency in autism. The "paradoxical" associations of OT levels and social skills in children with autism indicate disturbances at various levels of OT system. We first reported associations of OT levels in children with autism and behavioral measures in fathers indicating that OT abnormalities stay between parental autistic traits and autism symptoms in their children.     

Utility of the Gilliam Autism Rating Scale in research and clinical populations

The Gilliam Autism Rating Scale (GARS) was developed as a relatively easy, inexpensive aid in the surveillance and diagnosis of autism. This study examined the validity of the GARS when used with a sample of 119 children with strict DSM-IV diagnoses of autism, ascertained from both clinical and research settings. The GARS consistently underestimated the likelihood that autistic children in this sample would be classified as having autism. The sample mean for the Autism Quotient, a hypothesized index of the likelihood of having autism, was 90.10, significantly below the reference mean of 100. Diagnostic classification according to criteria specified by the GARS resulted in a sensitivity of only .48. Limitations of rating scales in general and of the GARS specifically are discussed. It is recommended that clinicians and researchers using or considering using the GARS for autism diagnosis or ratings of autism severity recognize the need for further research regarding its use.     

福建省儿童孤独症流行病学调查

目的 了解福建省儿童孤独症的患病及分布情况。方法 抽查福建省不同地区１４岁以下儿童共１０８０２人,采取ＡＢＣ量表筛查、ＣＣＭＤ－２－Ｒ及ＤＳＭ－Ⅲ－Ｒ确定诊断的方法。结果 确诊为儿童孤独症的共３名时患病率为０．２８‰。结论福建省儿童孤独症的患病率在国外的国外报道患病率范围之内应加强对儿童孤独症的研究。     

Association of serotonin concentration to behavior and IQ in autistic children

Twenty-five boys meeting DSM-III criteria for infantile autism were evaluated for IQ, age, and behavior score on the Autism Behavior Checklist (ABC), in order to determine the ability to predic platelet-rich plasma (PRP) serotonin concentrations. Multiple regression techniques were used to adjust the PRP serotonin concentration for medication and whole blood platelet count to allow meaningful comparisons of serotonin concentrations among the autistic children. Though we found no significant correlation between the adjusted serotonin concentration and the IQ, or between the adjusted serotonin concentration and the various ABC scale scores, four individual items of the ABC did correlate with the adjusted serotonin concentration. Individuals with all of these items appear to be more severely affected with the disorder of autism and have a tendency to higher adjusted PRP serotonin concentration.