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Rosen NE, Lord C, Volkmar FR. The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond. J Autism Dev Disord 2021; 51:4253-4270. [PMID: 33624215 PMCID: PMC8531066 DOI: 10.1007/s10803-021-04904-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 12/27/2022]
Abstract
In this paper we review the impact of DSM-III and its successors on the field of autism-both in terms of clinical work and research. We summarize the events leading up to the inclusion of autism as a "new" official diagnostic category in DSM-III, the subsequent revisions of the DSM, and the impact of the official recognition of autism on research. We discuss the uses of categorical vs. dimensional approaches and the continuing tensions around broad vs. narrow views of autism. We also note some areas of current controversy and directions for the future.
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Affiliation(s)
| | | | - Fred R. Volkmar
- Yale University, New Haven, USA
- Southern Connecticut State University, New Haven, USA
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2
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Martin KB, Hammal Z, Ren G, Cohn JF, Cassell J, Ogihara M, Britton JC, Gutierrez A, Messinger DS. Objective measurement of head movement differences in children with and without autism spectrum disorder. Mol Autism 2018; 9:14. [PMID: 29492241 PMCID: PMC5828311 DOI: 10.1186/s13229-018-0198-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 02/06/2018] [Indexed: 12/03/2022] Open
Abstract
Background Deficits in motor movement in children with autism spectrum disorder (ASD) have typically been characterized qualitatively by human observers. Although clinicians have noted the importance of atypical head positioning (e.g. social peering and repetitive head banging) when diagnosing children with ASD, a quantitative understanding of head movement in ASD is lacking. Here, we conduct a quantitative comparison of head movement dynamics in children with and without ASD using automated, person-independent computer-vision based head tracking (Zface). Because children with ASD often exhibit preferential attention to nonsocial versus social stimuli, we investigated whether children with and without ASD differed in their head movement dynamics depending on stimulus sociality. Methods The current study examined differences in head movement dynamics in children with (n = 21) and without ASD (n = 21). Children were video-recorded while watching a 16-min video of social and nonsocial stimuli. Three dimensions of rigid head movement—pitch (head nods), yaw (head turns), and roll (lateral head inclinations)—were tracked using Zface. The root mean square of pitch, yaw, and roll was calculated to index the magnitude of head angular displacement (quantity of head movement) and angular velocity (speed). Results Compared with children without ASD, children with ASD exhibited greater yaw displacement, indicating greater head turning, and greater velocity of yaw and roll, indicating faster head turning and inclination. Follow-up analyses indicated that differences in head movement dynamics were specific to the social rather than the nonsocial stimulus condition. Conclusions Head movement dynamics (displacement and velocity) were greater in children with ASD than in children without ASD, providing a quantitative foundation for previous clinical reports. Head movement differences were evident in lateral (yaw and roll) but not vertical (pitch) movement and were specific to a social rather than nonsocial condition. When presented with social stimuli, children with ASD had higher levels of head movement and moved their heads more quickly than children without ASD. Children with ASD may use head movement to modulate their perception of social scenes. Electronic supplementary material The online version of this article (10.1186/s13229-018-0198-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katherine B Martin
- 1Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146 USA
| | - Zakia Hammal
- 2Robotics Institute, Carnegie Mellon University, 5000 Forbes Ave, Pittsburgh, PA 15213 USA
| | - Gang Ren
- 3Center for Computational Science, University of Miami, 1320 S Dixie Hwy, Miami, FL 33146 USA
| | - Jeffrey F Cohn
- 4Department of Psychology, University of Pittsburgh, 210 S. Bouquet St., Pittsburgh, PA 15260 USA
| | - Justine Cassell
- 5Human Computer Interaction, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213 USA
| | - Mitsunori Ogihara
- 6Department of Computer Science, University of Miami, 1365 Memorial Drive, Coral Gables, FL 33146 USA
| | - Jennifer C Britton
- 1Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146 USA
| | - Anibal Gutierrez
- 1Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146 USA
| | - Daniel S Messinger
- 1Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146 USA
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3
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Morgan S. Diagnostic Assessment of Autism: A Review of Objective Scales. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2016. [DOI: 10.1177/073428298800600205] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Five objective scales for diagnosis of autism are evaluated with reference to psychometric criteria of reliability (test-retest, interrater, internal consistency) and validity (content, construct, concurrent, discriminant). The five scales are the Diagnostic Checklist for Behavior Disturbed Children (Form E-2), Behavior Observation Scale for Autism, Behavior Rating Instrument for Autistic and Atypical Children, Autism Screening Instrument for Educational Planning, and Childhood Autism Rating Scale. Although all scales have strengths and weaknesses, the Childhood Autism Rating Scale emerges as the strongest scale in terms of demonstrated psychometric properties.
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Abstract
This article presents a survey of the child behavior therapy literature, drawing upon reviews and outcome studies published in the past five years. A number of criticisms are made. Child behavior therapy research needs to acquire a greater developmental focus, conduct more complex functional analyses, place greater emphasis on assessment and description of subjects, and employ more consistent use of adequate designs and procedures. Recent work, nonetheless, reflects greater methodological and conceptual sophistication than was found in earlier reviews.
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5
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Roux S, Adrien JL, Bruneau N, Malvy J, Barthelemy C. Behaviour Profiles within a Population of 145 Children with Autism Using the Behaviour Summarized Evaluation Scale. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016. [DOI: 10.1177/1362361398024003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Clinicians and researchers have observed a degree of heterogeneity within the autistic syndrome which suggests different pathophysiological mechanisms. Greater understanding of this heterogeneity was sought by studying more homogeneous subpopulations according to developmental age (DA) within a large population of children with autism. The sample consisted of 145 children with autism (population P), and two subpopulations were determined according to DA criteria: DA < 2 years, population PDA-; DA? 2 years, population PDA+. An original multivariate descriptive statistical method, correspondence analysis, was applied to 13 behavioural data, followed by a classical hierarchical clustering method. In population P, four behaviour profiles were distinguished on the basis of three main functions: auditory perception, imitation and sensorimotility. The study of more homogeneous subpopulations according to DA revealed differences in the factorial structure of both subpopulations. In population PDA+ the main relevant behaviours defining profiles in autism were first abnormal reactivity to auditory stimuli, followed by imitation deficiences. However in population PDA-the main relevant behaviours were first stereotypies, followed by abnormal reactivity to auditory stimuli. Modification of the organization of behaviours in autism according to developmental age is clarified; unlike the auditory perception dimension, imitation and sensorimotor dimensions may be dependent on development. These results thus support the heterogeneity of the autistic syndrome and clarify some aspects of change and continuity in the expression of the disorders contained in this syndrome.
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6
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Vllasaliu L, Jensen K, Hoss S, Landenberger M, Menze M, Schütz M, Ufniarz K, Kieser M, Freitag CM. Diagnostic instruments for autism spectrum disorder (ASD). THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Leonora Vllasaliu
- University Hospital Frankfurt, Goethe University; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence Frankfurt; Deutschordenstraße 50 Frankfurt am Main Germany D 60528
| | - Katrin Jensen
- Heidelberg University Hospital; Institute of Medical Biometry and Informatics; Im Neuenheimer Feld 305 Heidelberg Germany 69120
| | - Stephanie Hoss
- University Hospital Frankfurt, Goethe University; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence Frankfurt; Deutschordenstraße 50 Frankfurt am Main Germany D 60528
| | - Marie Landenberger
- University Hospital Frankfurt, Goethe University; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence Frankfurt; Deutschordenstraße 50 Frankfurt am Main Germany D 60528
| | - Marianne Menze
- University Hospital Frankfurt, Goethe University; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence Frankfurt; Deutschordenstraße 50 Frankfurt am Main Germany D 60528
| | - Magdalena Schütz
- University Hospital Frankfurt, Goethe University; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence Frankfurt; Deutschordenstraße 50 Frankfurt am Main Germany D 60528
| | - Krystyna Ufniarz
- University Hospital Frankfurt, Goethe University; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence Frankfurt; Deutschordenstraße 50 Frankfurt am Main Germany D 60528
| | - Meinhard Kieser
- Heidelberg University Hospital; Institute of Medical Biometry and Informatics; Im Neuenheimer Feld 305 Heidelberg Germany 69120
| | - Christine M Freitag
- University Hospital Frankfurt, Goethe University; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence Frankfurt; Deutschordenstraße 50 Frankfurt am Main Germany D 60528
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Venkatesan S, Ravindran N. Autism Behavior Checklist for Disability Estimation: A Preliminary Field Tryout. PSYCHOLOGICAL STUDIES 2015. [DOI: 10.1007/s12646-015-0304-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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8
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Goldman S, Wang C, Salgado MW, Greene PE, Kim M, Rapin I. Motor stereotypies in children with autism and other developmental disorders. Dev Med Child Neurol 2009; 51:30-8. [PMID: 19087102 DOI: 10.1111/j.1469-8749.2008.03178.x] [Citation(s) in RCA: 196] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of the study was to count and characterize the range of stereotypies--repetitive rhythmical, apparently purposeless movements--in developmentally impaired children with and without autism, and to determine whether some types are more prevalent and diagnostically useful in children with autism. We described each motor stereotypy recorded during 15 minutes of archived videos of standardized play sessions in 277 children (209 males, 68 females; mean age 4y 6mo [SD 1y 5mo], range 2y 11mo-8y 1mo), 129 with autistic disorder (DSM-III-R), and 148 cognitively-matched non-autistic developmentally disordered (NADD) comparison children divided into developmental language disorder and non-autism, low IQ (NALIQ) sub-groups. The parts of the body involved and characteristics of all stereotypies were scored blind to diagnosis. More children with autism had stereotypies than the NADD comparison children. Autism and, to a lesser degree, nonverbal IQ (NVIQ) <80, especially in females contributed independently to the occurrence, number, and variety of stereotypies, with non-autistic children without cognitive impairment having the least number of stereotypies and children with autism and low NVIQ the most. Autism contributed independently to gait and hand/finger stereotypies and NVIQ <80 to head/trunk stereotypies. Atypical gazing at fingers and objects was rare but virtually limited to autism. Stereotypies are environmentally modulated movement disorders, some highly suggestive, but not pathognomonic, of autism. Their underlying brain basis and genetic correlates need investigation.
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Affiliation(s)
- Sylvie Goldman
- Saul R Korey Department of Neurology and Rose F Kennedy Center for Research in Mental Retardation and Human Development, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
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9
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Mawle E, Griffiths P. Screening for autism in pre-school children in primary care: Systematic review of English Language tools. Int J Nurs Stud 2006; 43:623-36. [PMID: 16387303 DOI: 10.1016/j.ijnurstu.2005.11.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2005] [Revised: 10/10/2005] [Accepted: 11/15/2005] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To review the accuracy of brief screening tools for autism in pre-school children. DESIGN Systematic review of diagnostic accuracy studies. DATA SOURCES Medline, Embase, Cinahl and Psychlit plus references of identified papers and contact with authors. SUBJECTS Children and infants aged 5 years or less without a prior diagnosis of autism or pervasive development delay. INTERVENTIONS Tools/checklists appropriate for use in screening for autism in primary care settings. OUTCOME MEASURES Sensitivity, specificity, positive and negative predictive value of screening tools and likelihood ratios relative to a diagnostic assessment made using either DSM-III/IV or ICD 10 diagnosis. RESULTS Three studies considering two tools were identified. The CHecklist for Autism in Toddlers (CHAT) was tested on an appropriate population sample with moderate long-term follow-up but demonstrated poor sensitivity and positive predictive value. Weaker evidence suggested that the Modified CHecklist for Autism in Toddlers (M-CHAT) had high sensitivity but follow-up was of shorter term and less comprehensive. CONCLUSIONS The CHAT demonstrated a level of sensitivity unlikely to be useful for population screening purposes, however, its high specificity suggests it has utility in secondary screening. The M-CHAT is a parent only report and might be more sensitive, and therefore appropriate for population screening. However, full conclusions regarding its accuracy cannot be drawn until follow-up data has been collected.
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Affiliation(s)
- Elizabeth Mawle
- Health Visitor, Westminster Primary Care Trust, 158 Herne Hill Road, London SE24 0AH, UK.
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10
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Berument SK, Starr E, Pickles A, Tomlins M, Papanikolauou K, Lord C, Rutter M. Pre-linguistic Autism Diagnostic Observation Schedule adapted for older individuals with severe to profound mental retardation: a pilot study. J Autism Dev Disord 2006; 35:821-9. [PMID: 16283083 DOI: 10.1007/s10803-005-0027-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The Autism Diagnostic Observational Schedule (ADOS) is a semi-structured observational scale developed to assess social interaction, communication and play in individuals who are suspected to have autism. Since the ADOS is not suitable to be used with severely or profoundly mentally retarded adolescents and adults with very limited language skills, materials and some of the tasks of the PL-ADOS and the original ADOS (the former versions of the current ADOS) were adapted. Results indicated that almost all of the overall ratings showed good reliability and discriminative diagnostic validity. Furthermore, the combination of codings into an overall algorithm score on social/communicative behavior resulted in a sensitivity of .82 and a specificity of .85 when using a cut-off score of 15.
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11
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Screening for Autism in Infants, Children, and Adolescents. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s0074-7750(06)32007-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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12
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Tordjman S. Les instruments d'évaluation de l'autisme : intérêts et limites. PSYCHIATRIE DE L ENFANT 2002. [DOI: 10.3917/psye.452.0533] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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13
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Robins DL, Fein D, Barton ML, Green JA. The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. J Autism Dev Disord 2001. [PMID: 11450812 DOI: 10.1023/a: 1010743030478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Autism, a severe disorder of development, is difficult to detect in very young children. However, children who receive early intervention have improved long-term prognoses. The Modified Checklist for Autism in Toddlers (M-CHAT), consisting of 23 yes/no items, was used to screen 1,293 children. Of the 58 children given a diagnostic/developmental evaluation, 39 were diagnosed with a disorder on the autism spectrum. Six items pertaining to social relatedness and communication were found to have the best discriminability between children diagnosed with and without autism/PDD. Cutoff scores were created for the best items and the total checklist. Results indicate that the M-CHAT is a promising instrument for the early detection of autism.
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Affiliation(s)
- D L Robins
- Department of Psychology, University of Connecticut, Storrs 06269-1020, USA
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14
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Robins DL, Fein D, Barton ML, Green JA. The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. J Autism Dev Disord 2001; 31:131-44. [PMID: 11450812 DOI: 10.1023/a:1010738829569] [Citation(s) in RCA: 756] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Autism, a severe disorder of development, is difficult to detect in very young children. However, children who receive early intervention have improved long-term prognoses. The Modified Checklist for Autism in Toddlers (M-CHAT), consisting of 23 yes/no items, was used to screen 1,293 children. Of the 58 children given a diagnostic/developmental evaluation, 39 were diagnosed with a disorder on the autism spectrum. Six items pertaining to social relatedness and communication were found to have the best discriminability between children diagnosed with and without autism/PDD. Cutoff scores were created for the best items and the total checklist. Results indicate that the M-CHAT is a promising instrument for the early detection of autism.
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Affiliation(s)
- D L Robins
- Department of Psychology, University of Connecticut, Storrs 06269-1020, USA
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15
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Vig S, Jedrysek E. Autistic features in young children with significant cognitive impairment: autism or mental retardation? J Autism Dev Disord 1999; 29:235-48. [PMID: 10425586 DOI: 10.1023/a:1023084106559] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This review addresses the issues and challenges related to the differential diagnosis of autism in preschool children with significant cognitive impairment. Issues affecting differential diagnosis include the use of traditional diagnostic guidelines for preschoolers with developmental delays, developmental changes in behavioral characteristics, the involvement of cognitive factors in symptom expression, and the overlap between autism and mental retardation in individuals with significant cognitive impairment. The usefulness of autistic features for differential diagnosis is explored in terms of the core deficits of autism.
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Affiliation(s)
- S Vig
- Children's Evaluation and Rehabilitation Center, Rose F. Kennedy Center, Albert Einstein College of Medicine, Bronx, New York 10461, USA
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16
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Orrico A, Hayek G. An additional case of craniodigital syndrome: variable expression of the Filippi syndrome? Clin Genet 1997; 52:177-9. [PMID: 9377808 DOI: 10.1111/j.1399-0004.1997.tb02540.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report on a boy with severe growth and mental retardation, syndactyly of toes and facial anomalies. This phenotype can easily be classified in the group of craniodigital syndromes, but it is difficult to make a more clearly defined diagnosis, based on other minor anomalies, because of the presence of overlapping features. On the basis of various pathognomic features, we conclude that our patient could be an additional case of Filippi syndrome. Moreover, newly recognised features in this patient may be due to variability in phenotypic expression.
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Affiliation(s)
- A Orrico
- Dipartimento di Biologia Molecolare, U.O. Genetica Medica, Policlinico Le Scotte, Siena, Italy
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17
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Miranda-Linné FM, Melin L. A comparison of speaking and mute individuals with autism and autistic-like conditions on the Autism Behavior Checklist. J Autism Dev Disord 1997; 27:245-64. [PMID: 9229257 DOI: 10.1023/a:1025846330262] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The item, total, and subscale scores on the Autism Behavior Checklist (ABC) were compared for 155 mute and 335 speaking individuals with autism spectrum disorders. Although no significant difference was observed between the groups on the ABC total score, the mute group demonstrated significantly more pathology on 21 of 57 items and 3 of 5 subscales. The speaking group obtained significantly higher scores on only 8 items and 1 subscale (Language). The appropriateness of providing greater pathology scores on expressive language items to speaking, rather than to mute, individuals is called into question. The authors speculate whether the expressive language items are weighted too heavily, in regard both to the Language subscale and to the ABC total score. If the expressive language items were removed, the mute group would have significantly higher ABC total scores and therefore a greater degree of autism severity.
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18
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Barthélémy C, Roux S, Adrien JL, Hameury L, Guérin P, Garreau B, Fermanian J, Lelord G. Validation of the Revised Behavior Summarized Evaluation Scale. J Autism Dev Disord 1997; 27:139-53. [PMID: 9105965 DOI: 10.1023/a:1025887723360] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The Behavioral Summarized Evaluation scale (BSE), previously published and validated, was developed for the evaluation for the autistic behavior in developmentally disorder children. A revised version of this scale, the Revised Behavior Summarized Evaluation Scale (BSE-R) completed the 20-item BSE scale with the most relevant items extracted from a similar evaluation carried out with very young children. Thus 9 items were added to the original scale concerning nonverbal communication, emotional, and perception areas. This paper reports the reliability and validity studies of this new scale. In addition to confirming the previously published findings concerning the first version of the BSE, new items were extracted from the BSE-R content validity study. They involve fundamental functions such as intention and imitation which open new perspectives for a physiopathological approach to developmental disorders. The BSE-R is a useful tool for progressive recording of the evolution of patients both treated over long periods and included in short-term controlled therapeutic studies.
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Affiliation(s)
- C Barthélémy
- Laboratoire de Neurophysiologie du Développement, INSERM U316, CHU Bretonneau, Tours, France
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19
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Yirmiya N, Sigman M, Freeman BJ. Comparison between diagnostic instruments for identifying high-functioning children with autism. J Autism Dev Disord 1994; 24:281-91. [PMID: 8050982 DOI: 10.1007/bf02172227] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Two instruments for identifying autism in children and adolescents with intellectual abilities in the normal range were compared. Diagnostic tools consisted of the Autism Behavior Checklist (ABC) and the Autism Diagnostic Interview (ADI). The sample was composed of 18 children who were all diagnosed as having either infantile autism or infantile autism, residual state based on DSM-III criteria by a clinical team using observations, parental interviews, and interactions with the children. Only 4 of the children met diagnostic cutoffs for autism on the current ABC but all met criteria for diagnosis on the ABC using parental recall of the child's behavior at 3-5 years of age. The ADI had somewhat greater specificity in that 3 children did not meet criteria for diagnosis although 2 of these children also received ABC scores based on parental recollection that were in the borderline range.
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Affiliation(s)
- N Yirmiya
- Department of Psychology, Hebrew University of Jerusalem, Mount Scopus, Israel
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20
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Vostanis P, Smith B, Chung MC, Corbett J. Early detection of childhood autism: a review of screening instruments and rating scales. Child Care Health Dev 1994; 20:165-77. [PMID: 8062410 DOI: 10.1111/j.1365-2214.1994.tb00378.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The detection and diagnosis of autism may be delayed until middle childhood, 3-4 years after its onset. This is more likely in high-functioning autism and in cases of co-morbidity with mental retardation. Such delays have serious effects on children and their families as well as on the provision of clinical and educational resources. In addition to greater awareness among professionals and to the development of comprehensive services, early detection could be facilitated by screening for early signs and symptoms of autism. The instruments that have been developed to rate autistic behaviours, particularly in pre-school children, are reviewed in this paper. Although the majority of these observational or informant-based measures were not initially designed for screening purposes, previous research findings from their application could be useful in the future development of such a screening instrument. Relevant research findings are discussed and suggestions are made for further evaluation in appropriate populations.
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Affiliation(s)
- P Vostanis
- Department of Psychiatry, University of Birmingham, UK
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21
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Barthélémy C, Adrien JL, Roux S, Garreau B, Perrot A, Lelord G. Sensitivity and specificity of the Behavioral Summarized Evaluation (BSE) for the assessment of autistic behaviors. J Autism Dev Disord 1992; 22:23-31. [PMID: 1592764 DOI: 10.1007/bf01046400] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The Behavior Summarized Evaluation (BSE), developed for the assessment of autistic behavior, was specifically designed to evaluate the severity of behavioral problems in autistic children involved in bioclinical and therapeutic studies. The reliability studies and the factorial analysis of this scale have been previously published. The present paper examines the effectiveness of the BSE to discriminate 58 autistic from 58 nonautistic mentally retarded children. The BSE clearly separated the two samples of children. A most efficient combination of 8 items emerged from the stepwise item selection procedure. The between-group differences were highest on 4 items, indicating that the most particular pattern in autistic compared to nonautistic children could be the association of autistic withdrawal and stereotypic behaviors. Our findings suggest that the BSE could help in the detection and evaluation of autistic developmental deviance. Implications for further research are discussed.
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Affiliation(s)
- C Barthélémy
- INSERM U.316, C. H. U. Bretonneau, Tours, France
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22
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Affiliation(s)
- K Aitken
- Department of Clinical Psychology, Royal Hospital for Sick Children, Edinburgh
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23
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Autism: Etiology, differential diagnosis, and behavioral assessment update. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 1991. [DOI: 10.1007/bf00961426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Barthelemy C, Adrien JL, Tanguay P, Garreau B, Fermanian J, Roux S, Sauvage D, Lelord G. The Behavioral Summarized Evaluation: validity and reliability of a scale for the assessment of autistic behaviors. J Autism Dev Disord 1990; 20:189-204. [PMID: 2347819 DOI: 10.1007/bf02284718] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Behavioral Summarized Evaluation (BSE), is a 20-item paper-and-pencil rating scale specifically designed for the measurement of behavioral parameters which could be related to biological data in autistic children involved in educational programs, neurophysiological studies, and therapeutic trials. The development of the scale, the validity, and reliability studies are presented in this paper. The results suggest that the BSE is an acceptable tool for the assessment of autistic behaviors, easy to handle, and accessible to both professionals and paraprofessionals of the medico-educative staff. It is a useful addition to the bioclinical researcher's evaluation battery for bioclinical and therapeutic studies. However, more work is suggested to further investigate the psychometric properties of this behavior assessment instrument.
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Affiliation(s)
- C Barthelemy
- Département de Psychopathologie et de Neurophysiologie du Développement, C.H.U. Bretonneau, Tours, France
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Kurita H, Miyake Y. The reliability and validity of the Tokyo Autistic Behaviour Scale. THE JAPANESE JOURNAL OF PSYCHIATRY AND NEUROLOGY 1990; 44:25-32. [PMID: 2362391 DOI: 10.1111/j.1440-1819.1990.tb00438.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Tokyo Autistic Behavior Scale (TABS) consisting of 39 items provisionally grouped in four areas--interpersonal-social relationship, language-communication, habit-mannerism and others--is an instrument used by a child's caretaker to rate the child's autistic behaviors on a 3-point scale. Test-retest reliability was satisfactory (i.e., an r for a total score was .94). Among six DSM-III diagnostic groups, infantile autism showed a significantly higher total TABS score than the other five groups, and a taxonomic validity coefficient was .54. An r between total scores of the TABS and the Childhood Autism Rating Scale--Tokyo Version was .59. The area scores showed a lower validity than the total score. The TABS appears to be a useful instrument to assess autistic behavior.
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Affiliation(s)
- H Kurita
- Division of Developmental Disorders, National Institute of Mental Health, NCNP, Ichikawa, Japan
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Lord C, Rutter M, Goode S, Heemsbergen J, Jordan H, Mawhood L, Schopler E. Autism diagnostic observation schedule: a standardized observation of communicative and social behavior. J Autism Dev Disord 1989; 19:185-212. [PMID: 2745388 DOI: 10.1007/bf02211841] [Citation(s) in RCA: 1225] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The Autism Diagnostic Observation Schedule (ADOS), a standardized protocol for observation of social and communicative behavior associated with autism, is described. The instrument consists of a series of structured and semistructured presses for interaction, accompanied by coding of specific target behaviors associated with particular tasks and by general ratings of the quality of behaviors. Interrater reliability for five raters exceeded weighted kappas of .55 for each item and each pair of raters for matched samples of 15 to 40 autistic and nonautistic, mildly mentally handicapped children (M IQ = 59) between the ages of 6 and 18 years. Test-retest reliability was adequate. Further analyses compared these groups to two additional samples of autistic and nonautistic subjects with normal intelligence (M IQ = 95), matched for sex and chronological age. Analyses yielded clear diagnostic differences in general ratings of social behavior, specific aspects of communication, and restricted or stereotypic behaviors and interests. Clinical guidelines for the diagnosis of autism in the draft version of ICD-10 were operationalized in terms of abnormalities on specific ADOS items. An algorithm based on these items was shown to have high reliability and discriminant validity.
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Affiliation(s)
- C Lord
- Department of Pediatrics, University of Alberta, Canada
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Rutter M, Schopler E. Autism and pervasive developmental disorders: concepts and diagnostic issues. J Autism Dev Disord 1987; 17:159-86. [PMID: 3610994 DOI: 10.1007/bf01495054] [Citation(s) in RCA: 245] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The purpose of this report is to bring up to date available information on the defining features and diagnostic issues relating to autism and related disorders. We review the validity of the syndrome based on our last review (Rutter, 1978; Schopler, 1978). Subsequent data have produced refinement in our understanding of both diagnostic criteria and the nature of the basic deficit. Controversies over both the boundaries and the heterogeneity within the autism syndrome are evaluated according to available evidence. Diagnostic rating instruments for expediting systematic sample selection are critiqued, and leads for new research directions are suggested.
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Kurita H. Variables relating to the mental development of children with infantile autism. THE JAPANESE JOURNAL OF PSYCHIATRY AND NEUROLOGY 1986; 40:161-8. [PMID: 2431182 DOI: 10.1111/j.1440-1819.1986.tb03138.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Among 54 variables studied in 194 autistic children, nine variables--meaningful words, pointing, eating without assistance, crane symptoms (maneuvers of letting a person manipulate an object by grasping his or her hand and bringing it close to the object), echolalia, changing clothes without assistance, speech loss (loss of once-emerged meaningful words before 30 months of age), establishment of toilet-training and diagnosis of MBD--were correlated significantly to the children's mental development levels with absolute values of Kendall's tau b over 0.2. A discriminant analysis showed that three positive correlates, i.e., meaningful words, pointing and echolalia, and a negative correlate, i.e., crane symptoms, were important in distinguishing between young autistics with and without unfavorable mental development and possible poor outcomes.
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Abstract
A proposal is outlined to provide a quantitative descriptive research frame for analyzing the organization of spontaneous behavior in autistic children within and across natural settings such as home, school, daycare centre, and playground. A number of research questions are formulated and appropriate analyses are suggested. In particular the project aimed to detect periodicities in behavior, guided probably by “clock-like” processes as have been found in the field of biological rhythms. A database has to be created by observing and notating a sufficient number of samples of behavior drawn from various settings in which the autistic children happen to live. Contrived settings may also be used;
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Ritvo ER, Freeman BJ, Geller E, Yuwiler A. Effects of fenfluramine on 14 outpatients with the syndrome of autism. JOURNAL OF THE AMERICAN ACADEMY OF CHILD PSYCHIATRY 1983; 22:549-58. [PMID: 6655169 DOI: 10.1097/00004583-198311000-00006] [Citation(s) in RCA: 95] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Freeman BJ, Ritvo ER, Tonick I, Guthrie D, Schroth P. Behavior observation system for autism: analysis of behaviors among autistic, mentally retarded, and normal children. Psychol Rep 1981; 49:199-208. [PMID: 7291416 DOI: 10.2466/pr0.1981.49.1.199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The Behavior Observation Scale is being developed to objectively differentiate autistic, normal, and mentally retarded children of ages 30 to 60 mo. Operational definitions and procedures are described and frequency data from 140 children are reported. Of 59 scale items 26 were significantly different among the subject groups. Further statistical analysis showed that to assess the diagnostic significance of a behavior both the frequency of occurrence per subject and the number of children exhibiting it must be considered concurrently. Methodological problems encountered when attempting to establish objective diagnostic data for the syndrome of autism are discussed.
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Freeman BJ, Schroth P, Ritvo E, Guthrie D, Wake L. The Behavior Observation Scale for autism (BOS): initial results of factor analysis. J Autism Dev Disord 1980; 10:343-6. [PMID: 6927660 DOI: 10.1007/bf02408293] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Freeman BJ, Guthrie D, Ritvo E, Schroth P, Glass R, Frankel F. Behavior Observation Scale: perliminary analysis of the similarities and differences between autistic and mentally retarded children. Psychol Rep 1979; 44:519-24. [PMID: 461644 DOI: 10.2466/pr0.1979.44.2.519] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
35 autistic and 30 mentally retarded children matched for both mean chronological and mental age were observed in a playroom. The frequencies of occurrence of 67 objectively defined behaviors were coded on the Behavior Observation Scale. Implication for determining the objective diagnosis of autism is discussed.
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