Boys with autism spectrum disorders show superior performance on the adult Embedded Figures Test

Weak central coherence is frequently studied using the Embedded Figures Test (EFT) yielding mixed and ambiguous results. In this study, the performance of 36 boys (9–14 years) with Autism Spectrum Disorders (ASD) is compared with that of 46 typical peers using both the children's and the adult version of the EFT. Only in the adult version did the ASD group outperform the controls in terms of accuracy. Corrected for age and pIQ, a subgroup of boys with Autistic Disorder (AD) showed superior perceptual processing capacities, while the performance of boys with PDD-NOS and Asperger Syndrome was in between that of those with AD and the controls. The findings strongly suggest that children and adolescents with ASD will only show superior results on visual-perceptual tests if the task complexity and thus their sensitivity is sufficiently high to challenge typically developing age-matched peers.     

Cutoffs, norms, and patterns of problem behaviors in children with an ASD on the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT-Part 3)

Challenging behaviors are common and persistent in persons with autism spectrum disorders (ASDs). Best practices dictate that symptoms of ASD and these co-occurring problems be identified and then treated at the earliest possible age. Having said this, there has been a dearth of available assessment methods to make sure identifications in infants and toddlers, particularly with respect to challenging behaviors. The Baby and Infant Screen for Children with aUtIsm Traits (Part 3) was designed specifically for this purpose. In study one, 312 children between 17 and 37 months and diagnosed with autism or PDD-NOS were individually assessed. Cutoff scores for total and subtest scores were established. In study 2, frequency and patterns of various challenging behaviors were evaluated. The meaning of these data is discussed for toddlers and infants with ASD.     

Molecular and Cytogenetic Analyses on Brazilian Youths with Pervasive Developmental Disorders

The Pervasive Developmental Disorders (PDDs) constitute a group of behavioral and neurobiological impairment conditions whose main features are delayed communicative and cognitive development. Genetic factors are reportedly associated with PDDs and particular genetic abnormalities are frequently found in specific diagnostic subgroups such as the autism spectrum disorders. This study evaluated cytogenetic and molecular parameters in 30 youths with autism or other PDDs. The fragile X syndrome was the most common genetic abnormality detected, presented by 1 patient with autism and 1 patient with PPD not-otherwise specified (PPD-NOS). One girl with PDD-NOS was found to have tetrasomy for the 15q11-q13 region, and one patient with autism exhibited in 2/100 metaphases an inv(7)(p15q36), thus suggesting a mosaicism 46,XX/46,XX,inv(7)(p15q36) or representing a coincidental finding. The high frequency of chromosomopathies support the hypothesis that PDDs may develop as a consequence to chromosomal abnormalities and justify the cytogenetic and molecular assessment in all patients with PDDs for establishment of diagnosis.     

Psychopharmacology in autism: an update

Autism spectrum disorders are characterized by impairment in social reciprocity, disturbances in language and communication, restricted interests and repetitive behaviors of various types, as defined by the DSM-IV. The neurobiological bases of these disorders are poorly understood, although several abnormalities have been found. Pharmacotherapy in autism spectrum disorders lacks a solid, reliable neurobiological basis and at present it is mainly directed at the so-called associated behavioral symptoms, with limited relevance to core symptoms. Atypical neuroleptics, especially risperidone, have been shown to be useful in the treatment of behavioral symptoms in autism. Recent trials with SSRIs did not show remarkable results, in spite of their promising potential role. Attention deficit and hyperactivity disorder medications may be useful for counteracting the additional features of hyperactivity and short attention span. Antiepileptics have shown promising results but there are no specific indications for them as of yet. Research is now directed at evaluating novel treatments and combined behavioral and pharmacologic treatments, since behavioral interventions are the mainstay of the early treatment of autism.An update of currently available pharmacological treatments is provided.     

Examination of adaptive behavior differences in adults with autism spectrum disorders and intellectual disability

Autism spectrum disorders (ASD) and intellectual disabilities (ID) are high prevalence developmental disabilities that co-occur at high rates. Furthermore, Axis I psychopathology is known to occur more frequently in individuals with ID than the general population. The problems are lifelong and can be major impediments to independent living. Despite this, little research with adults is available to determine the effects of these disabilities on specific adaptive skills. In this study, 337 adults were evaluated using the Vineland Adaptive Behavior Scale to assess the effects of these disabilities on looking at an ID, ID plus ASD, and ID and ASD plus Axis I psychopathology group. Adaptive skills were greatest for the ID group followed by the ID plus ASD, and ID and ASD plus psychopathology. Thus, the more handicapping conditions, the greater the skills deficits observed, particularly where psychopathology was concerned. As such, accurately identifying the causes of adaptive skill deficits will likely result in more precise and effective treatment.     

Clinical Utility of Autism Spectrum Disorder Scoring Algorithms for the Child Symptom Inventory-4

Few studies examine the clinical utility of autism spectrum disorder (ASD) rating scales for screening referrals to child psychiatry clinics. Parents/teachers from Long Island, NY, completed the Child Symptom Inventory-4, a DSM-IV-referenced rating scale for 6- to 12-year-old clinical referrals with an ASD (N = 317) or nonASD psychiatric (N = 191) diagnosis. Two separate groups of children attending public school, regular education classes in the same geographic area were also rated by their parents (N = 446) and teachers (N = 464). Stepwise forward regression generated a scoring algorithm based on a subset of all CSI-4 items that best differentiated ASD from nonASD children. ROC analyses indicated high levels of sensitivity/specificity for recommended ASD cutoff scores for parent and teacher ratings.     

Diagnostic Stability in Very Young Children with Autism Spectrum Disorders

Autism Spectrum Disorders (ASD) diagnosis in very young children may be delayed due to doubts about validity. In this study, 77 children received a diagnostic and developmental evaluation between 16 and 35 months and also between 42 and 82 months. Diagnoses based on clinical judgment, Childhood Autism Rating Scale, and the Autism Diagnostic Observation Schedule were stable over time. Diagnoses made using the Autism Diagnostic Interview were slightly less stable. According to clinical judgment, 15 children (19%) moved off the autism spectrum by the second evaluation; none moved onto the spectrum. Results indicate diagnostic stability at acceptable levels for diagnoses made at age 2. Movement off the spectrum may reflect true improvement based on maturation, intervention, or over-diagnosis at age 2.     

High Rates of Psychiatric Co-Morbidity in PDD-NOS

Rates of co-morbid psychiatric conditions in children with Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) are hardly available, although these conditions are often considered as more responsive to treatment than the core symptoms of PDD-NOS. Ninety-four children with PDD-NOS, aged 6–12 years were included. The DISC-IV-P was administered. At least one co-morbid psychiatric disorder was present in 80.9% of the children; 61.7% had a co-morbid disruptive behavior disorder, and 55.3% fulfilled criteria of an anxiety disorder. Compared to those without co-morbid psychiatric disorders, children with a co-morbid disorder had more deficits in social communication. Co-morbid disorders occur very frequently in children with PDD-NOS, and therefore clinical assessment in those children should include assessment of co-morbid DSM-IV disorders.     

Effect of Language and Task Demands on the Diagnostic Effectiveness of the Autism Diagnostic Observation Schedule: The Impact of Module Choice

The ADOS characterizes socio-communicative deficits in autism spectrum disorders (ASD). In this study the effect of module choice on ADOS classification was examined. For 74 participants (52 autism, 22 PDD-NOS), Module 1 and Module 2 were administered in a single session. Fifty-one participants maintained ADOS classification, with 17 more impaired on M2 and 6 more impaired on M1. For 64 participants (25 autism, 39 PDD-NOS), Module 2 and Module 3 were administered. Thirty-nine participants maintained classification, with 24 more impaired on M3 and 1 more impaired on M2. As expected, more impairment was indicated when a module with more language and task demands was administered. Clinical judgment of the most appropriate module for administration was found to be important.     

A Comparison of the Autism Treatment Evaluation Checklist (ATEC) and the Childhood Autism Rating Scale (CARS) for the Quantitative Evaluation of Autism

The purpose of this study was to evaluate scores generated from the Autism Treatment Evaluation Checklist (ATEC), a parent–rated measure, and those derived from professionally completed Childhood Autism Rating Scale (CARS) evaluations. A cohort of 56 participants diagnosed with an autism spectrum disorder was used for the study, and each child was evaluated independently by the parent using the ATEC and a health care professional using the CARS. The Spearman's rank correlation statistic ρ was used to evaluate the correlation between ATEC and CARS scores. It was observed that there was a significant correlation between total ATEC and CARS scores (ρ = .71). Specific domains in the ATEC evaluation significantly correlated with CARS scores. Sensitivity, specificity, and receiver operating characteristic confirmed the association between CARS and ATEC domains. The results help to validate the utility of the parentally completed ATEC in comparison with an established, professional-related measure of autism.