Autistic disorder versus other pervasive developmental disorders in young children: same or different?

AimTo assess plasma zinc and copper concentration in individuals with Asperger’s Syndrome, Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) and autistic disorder, and to analyze the efficacy of zinc therapy on the normalization of zinc and copper levels and symptom severity in these disorders.Subjects and methodsPlasma from 79 autistic individuals, 52 individuals with PDD-NOS, 21 individuals with Asperger’s Syndrome (all meeting DSM-IV diagnostic criteria), and 18 age and gender similar neurotypical controls, were tested for plasma zinc and copper using inductively-coupled plasma-mass spectrometry.ResultsAutistic and PDD-NOS individuals had significantly elevated plasma levels of copper. None of the groups (autism, Asperger’s or PDD-NOS) had significantly lower plasma zinc concentrations. Post zinc and B-6 therapy, individuals with autism and PDD-NOS had significantly lower levels of copper, but individuals with Asperger’s did not have significantly lower copper. Individuals with autism, PDD-NOS and Asperger’s all had significantly higher zinc levels. Severity of symptoms decreased in autistic individuals following zinc and B-6 therapy with respect to awareness, receptive language, focus and attention, hyperactivity, tip toeing, eye contact, sound sensitivity, tactile sensitivity and seizures. None of the measured symptoms worsened after therapy. None of the symptoms in the Asperger’s patients improved after therapy.DiscussionThese results suggest an association between copper and zinc plasma levels and individuals with autism, PDD-NOS and Asperger’s Syndrome. The data also indicates that copper levels normalize (decrease to levels of controls) in individuals with autism and PDD-NOS, but not in individuals with Asperger’s. These same Asperger’s patients do not improve with respect to symptoms after therapy, whereas many symptoms improved in the autism group. This may indicate an association between copper levels and symptom severity.

Autism Spectrum Disorders (ASDs) are characterized by pervasive impairments in communication, socialization, and repetitive behaviors or interests. While there is a growing interest in early ASDs, very few studies have looked at the nature of these impairments before age 3. In order to better strengthen early assessment and intervention for ASDs, more knowledge is needed in this area. The current studies aimed to determine if, and in what ways, communication impairments are present in infants and toddlers (17-37 months) diagnosed with autism and Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS). In the first study, infants with autism and PDD-NOS (i.e., the ASD group) were compared to typically developing infants. In the second study, three groups were compared: autism, PDD-NOS, and non-ASD related developmentally delayed. Differences in communication impairments were assessed using the endorsement of communication items found on the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT), Part 1. Differences in overall communication impairments were assessed, as well as differences on specific communication items. Results found that infants with an ASD exhibit greater communication impairments than do typically developing infants, with all items displaying significant differences. Additionally, significant differences were found in overall communication impairments between all three groups in the second study, with the majority of items differentiating between the groups. The implications of these results, as well as directions for future research, are discussed.

An examination of the relationship between communication and socialization deficits in children with autism and PDD-NOS

Social communication in autism spectrum disorder not improved by Theory of Mind interventions.

The Autism Diagnostic Observation Schedule-Generic (ADOS-G) is a semistructured, standardized assessment of social interaction, communication, play, and imaginative use of materials for individuals suspected of having autism spectrum disorders. The observational schedule consists of four 30-minute modules, each designed to be administered to different individuals according to their level of expressive language. Psychometric data are presented for 223 children and adults with Autistic Disorder (autism), Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS) or nonspectrum diagnoses. Within each module, diagnostic groups were equivalent on expressive language level. Results indicate substantial interrater and test-retest reliability for individual items, excellent interrater reliability within domains and excellent internal consistency. Comparisons of means indicated consistent differentiation of autism and PDDNOS from nonspectrum individuals, with some, but less consistent, differentiation of autism from PDDNOS. A priori operationalization of DSM-IV/ICD-10 criteria, factor analyses, and ROC curves were used to generate diagnostic algorithms with thresholds set for autism and broader autism spectrum/PDD. Algorithm sensitivities and specificities for autism and PDDNOS relative to nonspectrum disorders were excellent, with moderate differentiation of autism from PDDNOS.

1. Chris Plauche Johnson, MEd, MD* 1. *Editorial Board After completing this article, readers should be able to: 1. Characterize the deficits of a child who has autism. 2. Describe the role of observing linguistic and social development in children who have autism. 3. Implement a strategy for surveillance and screening of young children. 4. Discuss the management of autism, including the use of medication. Primary care physicians (PCPs) caring for 1,000 children in a general practice should expect approximately six of their patients to meet the diagnosis of an autism spectrum disorder (ASD). (1) The impact of this prevalence is illustrated by a 2004 survey of PCPs revealing that 44% cared for 10 or more patients who had an ASD. (2) The ASDs include: autistic disorder (AD), Asperger disorder, and pervasive developmental disorder—not otherwise specified (PDD-NOS), a threshold term used when a child meets some but not all criteria necessary for a diagnosis of either AD or Asperger disorder. Research has documented the positive benefit of developmental and behavioral intervention for children who have ASDs, particularly when it is initiated prior to 3 years of age. (3) Early recognition of ASDs also is important for timely genetic counseling because younger siblings of children diagnosed as having ASDs have a 10 times increased risk of also having an ASD. The purpose of this review is to help the clinician recognize signs of ASDs that occur before age 2 years. Because the signs of Asperger disorder usually appear later, they are not discussed. The term “autism” is used in this review to represent both AD and its milder form, PDD-NOS. Currently, autism is diagnosed infrequently in children younger than 3 years of age. The diagnostic process is prompted most often by parental concern about absent or delayed speech. However, signs of autism, especially deficits in social skills and in preverbal gestural language, are present …

The number of children diagnosed with Autism Spectrum Disorder (ASD) has increased in the past few years and the root cause of the symptom cannot yet be determined. The diagnosis today relies heavily on the observation of children's behaviors. This paper presents a technique to investigate the behavior factor associations, and to classify these relations using classification based on association (CBA). Our experiments used actual patient profiles from two hospitals in Thailand. This dataset was categorized by doctors into two types: Autism and Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS). Our analysis results show several interesting behavior patterns in autism disorder. These results provide valuable information for doctors to conduct further studies in the early intervention of autistic symptoms. The goal of our research is to develop a data analysis tool to aid doctors in the diagnosis process in the future.

A questionnaire (the Wing Subgroups Questionnaire, or WSQ) for subclassifying children with autism into one of Wing's three hypothesized subgroups was developed, and the validity of this measure was assessed. Forty parents of children with autism or pervasive developmental disorder not otherwise specified (PDDNOS) completed the questionnaire. Results indicated that the questionnaire has adequate external criterion-referenced validity with similar subgroup ratings made by clinicians, and good internal consistency. Furthermore, results revealed three distinct and separate subgroups corresponding to Wing's subclassification scheme. Other analyses suggested that Wing assignment based on the WSQ was independent of chronological age and age equivalents for social and daily living skills, but not independent of diagnosis of autism vs. PDDNOS, IQ, severity of autism, sex, receptive language mental age, and age equivalents for communication skills. Finally, a discriminant analysis indicated that, of all the dependent variables examined in the present study, the clinicians' Wing assignment was the best predictor of Wing assignment based on the parent-completed WSQ. These findings provide support for Wing's classification system, and suggest that the WSQ is a valid and useful tool for subclassifying individuals with autism.

Characteristic symptoms of autistic disorder (AD) can be the result of cognitive impairment which can be produced by specific neurological irregularities. Up until now a specific cognitive deficit in autism has not been found, although the majority of people with autism show intellectual impairment, verbal scores lower than manipulative measures and executive dysfunctions. A neuropsychological evaluation of children with AD was planned. These children had intellectual abilities in the normal range. They were compared with two other groups, one with pervasive developmental disorder not otherwise specified (PDD-NS), and the other from the general population. A battery of neuropsychological tests was carried out on five boys AD, five boys PDD-NS, and five boys of the general population. All of them were between 9 and 15 years old and their intellectual abilities were within the normal range. The children AD obtained verbal scores lower than their visual-perception scores. They also showed good dynamic coordination of movement. Scores in episodic memory tasks where executive strategies are needed were low. The characteristics described in the paper do not demonstrate a specific profile of the AD, but they can be useful in diagnoses and in planning treatment.

Background: Autism disorders which are also known pervasive developmental disorders as are very complex and heterogeneous group of chronic disorders that marked by early impairment in socialization, communication, and behavior. Atypical autism associated with severe mental retardation is more likely to be associated with significant hyperactivity and behavioral abnormalities, and thus this association intensifies the therapeutic challenge of autism disorders. Patients and methods: The case of a girl with atypical autism disorder associated with cognitive impairment is described, and expert opinion is presented. Results: Early during October, 2022, the mother of 4 years and 10 months girl consulted us about the possible therapies for her girl who had the two major diagnostic features of autism (Poor response to own name and very poor eye contact. The girl was not interacting with anyone, and her speech was not developed. She also had repetitive movements mostly in the form of moving back and forth walk and some tapping of fingers with each other. Her motor development was acceptable, but she had poor understanding of commands and poor adaptive behaviors. The girl in this paper received the diagnosis of atypical autism with mental retardation, and was initially treated based on our extensive published experiences with treatment of autism disorders associated with cognitive impairment. Conclusion: The current expert opinion suggests treatment of children with atypical autism associated with mental retardation represents a therapeutic challenge and demands the judicious uses of several therapies including intramuscular cerebrolysin, piracetam, neuroleptics, The addition of baclofen has been suggested in the treatment of atypical associated with marked hyperactivity.

He could fit in the palms of both hands, seemed to look at you beseechingly while you rushed to thread a vein and snake a tube down a tiny nostril of this 24 week preemie. Already exposed to the prenatal stress that culminated in premature delivery, he has been further exposed to the stress associated with the separation from his mother and multiple medical interventions. Like other premature babies, he is more vulnerable to invasive infections from bacteria and viruses; moreover, the delayed development of his gut-blood-brain barriers could expose him to potential neurotoxins. Such infants are up to 4 times more likely to develop autism. If their mothers had allergies, mastocytosis or an autoimmune disease, this risk almost doubles. Autism Spectrum Disorders (ASD) are pervasive developmental disorders that include Autistic Disorder and Asperger’s Disorder, although Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) is frequently included (Johnson & Myers, 2007). ASD are characterized by variable deficits in social skills, stereotypic behaviors, and a wide range of behavioral and learning problems. ASD manifest during early childhood and at least 30% present with sudden clinical regression of development around 3 years of age (Matson J.L. & Kozlowski A.M., 2010; Zappella, 2010). Over the last 20 years, there has been an impressive rise in ASD with current prevalence estimates of 1/100 children (Fombonne, 2009; Kogan et al., 2009). In the majority of cases, the cause of ASD is unknown (Levy et al., 2009). Some autism susceptibility genes have been identified (Weiss et al., 2009), but gene interactions with environmental factors are increasingly suspected (Deth et al., 2008; Herbert, 2010). Recent reviews have focused mostly on genomic screens that suggest there are multiple gene interactions in autism; however no gene abnormality alone can explain the apparent increase in ASD prevalence (Durkin et al., 2010; Herbert, 2010; Miles, 2011). Increasing evidence suggests that there are different ASD endophenotypes, even within the ASD spectrum (Palmieri & Persico, 2010).

BackgroundNumerous medications have been tested on patients with pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger’s disorder. Although many of these medications have been demonstrated to be useful, no clear primary treatment for PDD-NOS and Asperger’s disorder has emerged. Despite the efficacy of some of the medicines, the acceptability and side effects have proven to be barriers to their use. Recent studies indicate that the traditional Japanese herbal medicine yokukansan (TJ-54) may be safe and useful in treating behavioral and psychological symptoms in dementia and some neuropsychiatric disorders. We aimed at evaluating both the efficacy and safety of TJ-54 in patients with well-defined PDD-NOS and Asperger’s disorder.MethodsThis was a 12-week prospective, open-label investigation of TJ-54 in 40 children, adolescents, and adults diagnosed with PDD-NOS or Asperger’s disorder. Primary outcome measures included the Clinical Global Impressions-Severity of Illness Scale (CGI-S) and the Aberrant Behavior Checklist-Iritability subscale score (ABC-I).ResultsForty subjects, ages 8–40 years (mean 22.7 ± 7.3 years) received a mean final TJ-54 dosage of 6.4 ± 1.3 g/day (range 2.5-7.5 g/day). Full-scale intelligence quotient (IQ) scores ranged from 70 to 110 (mean 88.9 ± 13.2). Thirty-six (90%) of 40 subjects showed fewer interfering symptoms of irritability, including aggression, self-injury, and tantrums, with a final CGI-S of 1 or 2 (normal, not at all ill or borderline mentally ill) and a 80% or greater improvement on the ABC-I. The mean CGI-S score at baseline was 6.8 ± 0.8 whereas scores at end point was 1.9 ± 0.1 (< 0.0001). ABC-I scores ranged from 11 to 29 (mean 17.4 ± 3.66) at baseline, whereas scores at week 12 ranged from 0 to 5 (mean 0.93 ± 0.97) (p <0.0001). TJ-54 was well tolerated. No subject exited the study due to a drug-related adverse event.ConclusionsThese preliminary data suggest that TJ-54 may be effective and well tolerated for treatment of severe irritability, lethargy/withdrawal, stereotypic behavior, hyperactivity/noncompliance, and inappropriate speech in patients with PDD-NOS or Asperger’s disorder. However, given the characteristics of this trial, the present findings should be taken cautiously, and larger-scale placebo-controlled studies are needed to elucidate the efficacy and tolerability of TJ-54 in this understudied population.

Sleep problems are a common occurrence in the typically developing population. These problems are even more frequent in those with developmental disabilities; however, sleep disorders are often under diagnosed in this population in clinical populations. Currently, there is a lack of research that examines the rate of sleep problems in adults with Autism Spectrum Disorders (ASD). The purpose of this study is to examine differences in the endorsements of sleep problems between three groups: 71 adults with Autistic Disorder (AD) and intellectual disability (ID), 71 adults with Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) and ID, and 71 adults with ID only, as assessed by the Diagnostic Assessment for the Severely Handicapped- Second Edition (DASH-II). The DASH-II, which includes a sleep scale, was designed to screen for psychopathology in those with severe to profound ID. Participants among the three groups did not differ significantly on total sleep scores or on individual items within the subscale. Follow up regression analysis examining what factors (i.e., ASD group, age, presence of psychotropic medications, presences of a non ASD Axis 1 diagnosis, and level of ID) predicted sleep problems found that the only significant predictor was presence of psychotropic medications. Implications and limitations of the study are discussed.

The diagnostic category pervasive developmental disorders (PDDs) refer to a group of five disorders: autism, Rett syndrome, childhood disintegrative disorder, Asperger syndrome, and pervasive developmental disorder not otherwise specified (PDD-NOS). EEG abnormalities and seizures are considered much frequent in autistic subjects with comorbid intellectual disability (ID). In this study, we aimed to evaluate the EEG and MRI findings and their relation with ID in pervasive developmental disorder. A retrospective, cross-sectional and non-experimental study was performed. Subjects included 81 patients diagnosed with autism or PDD-NOS according to the DSM-IV criteria. The age range of the patients was 2-15 years (mean 6.6 years, SD 3.0). Among them, 21 (25.9%) were girls and 60 boys (74.1%). Patients with severe ID had a higher rate of EEG abnormalities (P=0.03) than patients without ID as well as patients with mild or moderate ID. The association remained significant after the structural MRI abnormalities were controlled (P=0.04). The severity of ID was not associated with abnormal MRI. The most frequent EEG and MRI abnormalities were active epileptic anomaly/paroxysmal abnormality and cerebral atrophy/periventricular leukomalacia, respectively. Almost a third of the EEG abnormalities were associated with temporal cortex and adjacent cortical structures. Consistent with previous studies, almost a fourth of the patients in this relatively large sample of patients with pervasive developmental disorders had EEG and/or MRI abnormalities. EEG results indicate that temporal cortex may play a significant role in pervasive developmental disorders.

Does augmentation or induction of labor with oxytocin increase the risk for autism?