Sleep Disturbances in Adults with Autism Spectrum Disorders and Severe Intellectual Impairments

Sleep disturbances are a significant problem for persons with developmental disabilities. These problems occur at a higher rate than what is observed in the typically developing population, and persons with Autism Spectrum Disorders (ASD) appear to be at a higher risk than individuals with other developmental disabilities. However, another major risk is intellectual disability (ID). These two groups of disorders overlap to a substantial degree. Thus, persons with ASD and ID appear to be particularly susceptible to sleep disturbances. These sleep problems can have serious consequences beyond sleep, particularly with respect to increased challenging behaviors and as an impediment to learning. Despite these concerns, adults with ASD and ID have been largely neglected with respect to the study of these nocturnal difficulties. In this report, 168 adults with ASD and ID were compared to 166 adults with ID alone in regard to sleep disturbance and related difficulties. Individuals in the ASD group presented with much higher rates of sleep disturbances, and greater severity of sleep disorder was related to the expression of more serious challenging behaviors. The implications of our results are discussed for future assessment and treatment of these disorders.     

Validity and reliability of the Korean Version of Autism Spectrum Disorders-Diagnostic for Children (ASD-DC)

The purpose of the present study was to develop and evaluate the psychometric properties of the Autism Spectrum Disorders-Child (ASD-DC). Mothers of children with Autism spectrum disorders (N = 333) and mothers of typically developing children (N = 223) ages from 2 to 16 years completed the ASD-DC. The confirmatory factor analysis revealed that the 4-factor structure of the ASD-DC fits the data well, comprising the following factors: nonverbal communication/socialization, verbal communication, social relationships, and insistence of sameness/restricted interests. The ASD-DC was associated with high internal consistency and test–retest reliability. The discriminant validity was demonstrated by the mean differences between ASD and control group. High correlations between several subscales of ASD-DC and Social Communication Questionnaire (SCQ) were found, showing concurrent validity. High correlations between several subscales were found. Optimal cutoff scores for Autism, Asperger's disorder, and PDD-NOS were found via ROC curve analysis. Clinical and research implications as well as limitations are discussed.     

Social and communication behaviours in infants and toddlers with autism and pervasive developmental disorder-not otherwise specified

Purpose: Autism Spectrum Disorders (ASD) are a group of conditions characterized by symptoms that onset in early childhood. Deficits in social skills and communication are two of the core features of ASD and, if not remediated, can lead to poor long-term outcomes. Few researchers have examined characteristics of social skills and communication in infants with ASD.

Method: The social skills and communicative ability of 886 infants and toddlers 17–37 months of age with autism, PDD-NOS or ‘at risk’ for other developmental delays were evaluated using the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT). A Kruskal-Wallis test with follow-up Mann-Whitney tests were used to test for significance.

Results: Infants and toddlers with autism, followed by PDD-NOS, had greater social and communication deficits than children ‘at risk’ for developmental delays. Items which distinguished between these diagnostic groups were determined.

Conclusions: Outcomes suggest that social and communication deficits can be identified at early ages in a population of developmentally delayed toddlers. Implications are that pinpointing emerging social and communicative autistic traits earlier will allow for more accurate assessment and diagnosis in infants with ASD. This translates into earlier intervention and more effective treatment practices.     

Differentiating Among Children with PDD-NOS,ADHD, and those with a Combined Diagnosis on the Basis of WISC-III Profiles

Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) and Attention Deficit/Hyperactivity Disorder (ADHD) have partly overlapping symptoms. It can also be debated whether a third diagnostic category exists: children with a combined diagnosis. In this study an attempt was made to distinguish among the three groups on the basis of intelligence (WISC-III) profiles. It was found that the PDD-NOS group had higher verbal and performance IQ’s, as well as higher WISC-III index scores than the ADHD group. Subtests Block Design and Mazes discriminated best. It was concluded that based on intelligence scores, only PDD-NOS and ADHD emerged as distinct categories, whereas the combined diagnosis did not. Future research on the distinctiveness of these diagnostic groups, however, should include variables other than IQ.     

Association of a Monoamine Oxidase-A Gene Promoter Polymorphism With ADHD and Anxiety in Boys With Autism Spectrum Disorder

The aim of the present study was to examine the association between a variable number tandem repeat (VNTR) functional polymorphism in the promoter region of the MAO-A gene and severity of ADHD and anxiety in boys with ASD. Parents and teachers completed a DSM-IV-referenced rating scale for 5- to 14-year-old boys with ASD (n = 43). Planned comparisons indicated that children with the 4- versus 3-repeat allele had significantly (p < 05) more severe parent-rated ADHD inattention and impulsivity, and more severe teacher-rated symptoms of generalized anxiety. Our results support a growing body of research indicating that concomitant behavioral disturbances in children with ASD warrant consideration as clinical phenotypes, but replication with independent samples is necessary to confirm this preliminary finding.     

Parental Recognition of Developmental Problems in Toddlers with Autism Spectrum Disorders

Symptoms of Autism Spectrum Disorders (ASD) begin to manifest during the first 2 years; there is limited evidence regarding type and timing of symptom onset. We examined factors related to parental age of recognition (AOR) of early abnormalities and the association between AOR and diagnosis and levels of functioning at 2 and 4 years in 75 toddlers with ASD. Results suggest significant differences between autism and PDD-NOS in the AOR and type of first concerns. Early social and motor delays as well as maternal age was associated with AOR. Later AOR was associated with poorer social-communicative and nonverbal cognitive functioning at 2 and 4. The findings are discussed in a context of identifying distinct developmental trajectories within the autism spectrum.     

Face and Emotion Recognition in MCDD Versus PDD-NOS

Previous studies indicate that Multiple Complex Developmental Disorder (MCDD) children differ from PDD-NOS and autistic children on a symptom level and on psychophysiological functioning. Children with MCDD (n = 21) and PDD-NOS (n = 62) were compared on two facets of social-cognitive functioning: identification of neutral faces and facial expressions. Few significant group differences emerged. Children with PDD-NOS demonstrated a more attention-demanding strategy of face processing, and processed neutral faces more similarly to complex patterns whereas children with MCDD showed an advantage for face recognition compared to complex patterns. Results further suggested that any disadvantage in face recognition was related more to the autistic features of the PDD-NOS group rather than characteristics specific to MCDD. No significant group differences emerged for identifying facial expressions. This work was conducted in the Department of Child and Adolescent Psychiatry, Erasmus Medical Center/Sophia Children’s Hospital, Rotterdam.     

Relationship between motor and executive functioning in school-age children with pervasive developmental disorder not otherwise specified

This study examines the motor skills and executive functioning (EF) of 28 children diagnosed with pervasive developmental disorder-not otherwise specified (PDD-NOS; mean age: 10 years 6 months, range: 7-12 years; 19 boys, 9 girls) in comparison with age- and gender-matched typically developing children. The potential relationship between motor performance and EF in children with PDD-NOS is investigated as well. The children's motor skills were evaluated with the Movement ABC. EF, in terms of planning ability, strategic decision making, and problem solving, was gauged with the Tower of London (TOL) task. Compared with their typically developing peers, the children with PDD-NOS scored poor on the Movement ABC (p < 0.01) and the TOL (p < 0.05). They had significantly more definite motor problems than the normative sample of the Movement ABC: 43% (manual dexterity, p < 0.001), 25% (ball skills, p < 0.001), and 25% (balance skills, p < 0.001). There were significant inverse relationships between manual dexterity and the TOL score (r = −0.46, p < 0.01), and balance and the TOL score (r = −0.41, p < 0.05), indicating that children with a better performance on the manual dexterity subtest and the balance subtest had a better TOL score than children with a worse performance. Children with PDD-NOS have inferior motor skills, and these deficits are interrelated with planning ability, strategic decision making, and problem solving.     

The Autism-Spectrum Quotient (AQ) Children’s Version in Japan: A Cross-Cultural Comparison

In the current study, the child AQ was administered in Japan, to examine whether the UK results for reliability and validity generalize to a different culture. Assessment groups were: Group 1: n = 81 children with Asperger Syndrome (AS) or high-functioning autism (HFA); Group 2: n = 22 children diagnosed PDD-NOS with average IQ; and Group 3: n = 372 randomly selected controls from primary and secondary schools. Both clinical groups scored significantly higher than controls (AS/HFA mean AQ = 31.9, SD = 6.93; PDD-NOS mean AQ = 28.0, SD = 6.88; controls mean AQ = 11.7, SD = 5.94). Among the controls, males scored significantly higher than females. The pattern of difference between clinical groups and controls was found to be similar in both countries.     

The Autism Diagnostic Observation Schedule: Revised Algorithms for Improved Diagnostic Validity

Autism Diagnostic Observation Schedule (ADOS) Modules 1–3 item and domain total distributions were reviewed for 1,630 assessments of children aged 14 months to 16 years with an autism spectrum disorder (ASD) or with heterogeneous non-spectrum disorders. Children were divided by language level and age to yield more homogeneous cells. Items were chosen that best differentiated between diagnoses and were arranged into domains on the basis of multi-factor item-response analysis. Reflecting recent research, the revised algorithm now consists of two new domains, Social Affect and Restricted, Repetitive Behaviors (RRB), combined to one score to which thresholds are applied, resulting in generally improved predictive value.