Stereotyped behaviours in children with autism spectrum disorders and atypical development as measured by the BPI-01.

OBJECTIVE: As repetitive behaviours in children with autism spectrum disorders (ASDs) can significantly interfere with one's daily functioning, continued research on these behaviours is needed. METHODS: This study examined the occurrence of repetitive motor movements in toddlers (17-37 months) with ASD and atypical development and the relationship between stereotypies and sensory impairment. RESULTS: Children with ASD (n = 13) exhibited significantly more repetitive behaviours than the non-ASD group (n = 12). Greater percentages of endorsement were evident for the ASD group on nearly all items of the Behaviour Problems Inventory-01 (BPI-01) Stereotypy subscale. More repetitive behaviours tended to co-occur with other stereotypies for the ASD group. A moderate correlation was found between stereotypy severity and sensory deficits. CONCLUSION: These findings suggest that stereotyped behaviours can be identified at very young ages, negatively affect the behavioural presentation of those with ASDs and should be considered when developing treatment plans.

Pica in persons with developmental disabilities: approaches to treatment.

Pica is a very serious problem in which an individual ingests substances without nutrition value, such as paper and paint. As this behavior is often life-threatening resulting in surgery, pica has received attention from researchers for several decades. During that time, a number of interventions have been devised, such as behavioral methods (e.g., aversive stimuli, overcorrection, time-out, reinforcement) and biological interventions (e.g., pharmacotherapy, nutritional supplements). This paper is a broad review of the research on treatment studies for this problem, with a focus on persons with autism and/or intellectual disability (ID), which constitutes almost all of the published treatment papers. In addition, strengths and weaknesses of different pica treatments are discussed. Upon review, applied behavior analysis (ABA) was found to have the most robust empirical support to treat this behavior. Most clinicians are drifting away from aversive techniques and relying on more positive procedures to guide their treatment plans. The implications of current status and future directions for research are also addressed.

A comparison of diagnostic criteria on the Autism Spectrum Disorder Observation for Children (ASD-OC).

BACKGROUND: The Autism Spectrum Disorder Observation for Children (ASD-OC) is a new observation scale used to assess autistic symptomatology. As the publication of the fifth edition Diagnostic and Statistical Manual (DSM) is approaching, exploring the effect of the changing DSM criteria has begun to occur. OBJECTIVE: The aim of this study was to compare severity of autistic impairment in children diagnosed with either the DSM-IV-TR or the DSM-5. METHODS: ASD-OC total scores were compared between 63 children (3-15 years) in one of three groups: DSM-IV-TR group, DSM-5 group or control group. RESULTS: The DSM-5 and DSM-IV-TR groups evinced significantly higher ASD-OC scores as compared to the control group; however, there were no significant differences between the DSM-5 and DSM-IV-TR groups in symptom severity. CONCLUSION: Many children who are currently diagnosed with ASD may no longer be diagnosed, despite having significant impairments roughly equal to those who meet DSM-5 criteria.

How does relaxing the algorithm for autism affect DSM-V prevalence rates?

Although it is still unclear what causes autism spectrum disorders (ASDs), over time researchers and clinicians have become more precise with detecting and diagnosing ASD. Many diagnoses, however, are based on the criteria established within the Diagnostic and Statistical Manual of Mental Disorders (DSM); thus, any change in these diagnostic criteria can have a great effect upon children with ASD and their families. It is predicted that the prevalence of ASD diagnoses will dramatically decrease with the adoption of the proposed DSM-5 criteria in 2013. The aim of this current study was to inspect the changes in prevalence first using a diagnostic criteria set which was modified slightly from the DSM-5 criteria (Modified-1 criteria) and again using a set of criteria which was relaxed even a bit more (Modified-2 criteria). Modified-1 resulted in 33.77 % fewer toddlers being diagnosed with ASD compared to the DSM-IV, while Modified-2 resulted in only a 17.98 % decrease in ASD diagnoses. Children diagnosed with the DSM-5 criteria exhibited the greatest levels of autism symptomatology, but the Mod-1, Mod-2, and DSM-IV groups still demonstrated significant impairments. Implications of these findings are discussed.

Repetitive/restricted behaviours and interests in children with cerebral palsy and autism spectrum disorder.

OBJECTIVE: To inspect the presence and severity of deficits in restricted and/or repetitive behaviours and interests (RRBIs) in children with cerebral palsy (CP) and autism spectrum disorders (ASDs). METHODS: Children studied (18-35 months of age) belonged to one of three diagnostic groups: children with CP and autism (n = 11), children with CP and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS; n = 10) and children with a sole diagnosis of CP (n = 15). A one-way, between subjects ANOVA was conducted on the Repetitive Behaviour/Restricted Interests domain of the Baby and Infant Screen for aUtIsm Traits-Part 1 (BISCUIT-Part 1) and followed up with post-hoc tests. Percentage endorsements were also calculated for each item of this domain. RESULTS: Children with CP + autism had significantly greater impairment. No significant differences were found between the CP + PDD-NOS and the CP alone groups. CONCLUSION: The implications of these findings are discussed.

DSM-IV vs DSM-5 diagnostic criteria for toddlers with autism.

PURPOSE: To evaluate prevalence rates of autism and autism symptomatology in toddlers using DSM-IV vs DSM-5 criteria. METHOD: Two thousand seven hundred and twenty-one toddlers at risk for a developmental disability participated. DSM-IV and DSM-5 criteria were applied and overall prevalence using each set of criteria was established. Groups were also compared on BISCUIT-Part 1 scores to determine if groups differed on autism symptomatology. RESULTS: DSM-5 resulted in 47.79% fewer toddlers being diagnosed with ASD compared to those on the DSM-IV. Toddlers diagnosed according to DSM-5 exhibited greater levels of autism symptomatology than those diagnosed with DSM-IV, but the latter group still exhibited significant levels of autism symptomatology. CONCLUSION: The proposed DSM-5 will result in far fewer persons being diagnosed with ASD. These results replicate findings from two previous studies, with older children/adolescents and adults. As a result of these new criteria, far fewer people will qualify for needed autism services.

The effects of diagnostic group and gender on challenging behaviors in infants and toddlers with cerebral palsy, Down syndrome or seizures.

Challenging behaviors are frequently studied in individuals with various developmental disabilities, although specific conditions are rarely compared to one another. Such data would be informative to clinicians who assess and develop treatment plans for children with these disabilities. For that reason, the current study's aim was to analyze problem behavior deficits in infants and toddlers diagnosed with cerebral palsy (CP), Down syndrome (DS), and a history of seizures/seizure disorder. Seventy six children participated in this study and were administered the Baby and Infant Screen for Children with aUtIsm Traits-Part 2 (BISCUIT-Part 2). Inspection of the Tantrum/Conduct Behavior subscale of this measure revealed that children with a history of seizures/seizure disorder exhibited significantly higher scores, indicating greater impairment, than those with CP or DS. Children with DS and those diagnosed with CP did not significantly differ from one another. Additionally, there was no significant main effect by gender. The CP and DS groups also had fewer endorsements on all 18 items of the subscale as compared to the seizures group. Implications of these results are discussed.

Scaling methods to measure psychopathology in persons with intellectual disabilities.

Psychopathology prior to the last four decades was generally viewed as a set of problems and disorders that did not occur in persons with intellectual disabilities (ID). That notion now seems very antiquated. In no small part, a revolutionary development of scales worldwide has occurred for the assessment of emotional problems in persons with ID. The first standardized test to emerge was the Psychopathology Instrument for Mentally Retarded Adults (PIMRA) in 1984. Since that time, an impressive number of measures of general psychopathology have emerged for adults and children as well as for persons across the full range of levels of ID. The purpose of this review was to provide a description of available measures, to review papers published on these measures, and to discuss emerging trends in test development. The trends in this body of information for enhancing differential diagnosis of psychopathology in persons with ID are discussed.

Communication deficits in infants and toddlers with developmental disabilities.

Research that focuses on detecting and assessing the presence of communication impairments in children with developmental disabilities exists. However, more research is needed which compares these deficits across individuals with various developmental disabilities. This information could inform the assessment process and treatment programs. Therefore, the purpose of the current study was to examine communication deficits in toddlers who were diagnosed with Down syndrome, Cerebral Palsy (CP), had a history of seizures or a seizure disorder, and who were born premature. A total of 140 toddlers 17-35 months of age met inclusion criteria for the study. Those diagnosed with CP evinced significantly fewer communication impairments on the Baby and Infant Screen for aUtIsm Traits-Part 1 (BISCUIT-Part 1) than children with Down syndrome and children with a history of seizures or seizure disorder. No significant differences were found on the communication subscale for the comparison of those with CP and those born prematurely. Children diagnosed with CP had fewer endorsements, indicating less impairment, on all six items of the Communication subscale of the BISCUIT-Part 1 when compared to the three other diagnostic groups. Implications of these results are discussed for children with differing handicaps.

The effects of gender and age on repetitive and/or restricted behaviors and interests in adults with autism spectrum disorders and intellectual disability.

Frequency of repetitive and/or restricted behaviors and interests (RRBIs) was assessed in 140 adults with autism spectrum disorders (ASDs) and severe or profound intellectual disability (ID). The associations of gender and age range were analyzed with RRBI frequency which was obtained using the Stereotypies subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II). A significant main effect of gender was found. Male participants had higher frequency of RRBIs than females regardless of age range. There was not a significant main effect of age range or a significant interaction between gender and age range. Results and implications are discussed.

The occurrence of challenging behaviours in children with autism spectrum disorders and atypical development.

OBJECTIVE: This study examines the occurrence of challenging behaviours in children with ASDs and atypical development. DESIGN: This study is a descriptive non-experimental design that inspects the frequencies of challenging behaviours among two diagnostic groups. This type of methodology is important since research in this area is still in the beginning stages of development. METHODS: The sample consisted of 2131 children, with 633 having an ASD and 1498 having atypical development. The Baby and Infant Screen for Children with aUtIsm Traits-Part 3 (BISCUIT-Part 3) assesses problematic behaviours within this population. The frequencies of challenging behaviours were examined along with an inspection of the co-occurring items. RESULTS: Greater percentages of problematic behaviours were found in the ASD group as compared to the group with atypical development. CONCLUSION: Challenging behaviours are variables affecting the behavioural presentation of those with ASDs and may be considered into the treatment plans for these children.

The relationship between psychopathology symptom clusters and the presence of comorbid psychopathology in individuals with severe to profound intellectual disability.

In the typically developing population, comorbid psychopathology refers to the co-occurrence of two different psychopathologies other than cognitive impairments. With respect to individuals with intellectual disability, comorbidity is often described as cognitive deficits and one additional psychopathology manifesting together. However, just as within the typically developing population, individuals with intellectual disability may also present with symptoms of two or more additional disorders. The presentation of these symptom clusters may similarly correlate. Therefore, the current study used the Diagnostic Assessment for the Severely Handicapped-II in order to examine relationships between psychopathological symptom clusters in adults with severe to profound intellectual disability. Additionally, we assessed comorbid presentation of disorders other than cognitive impairments in these same adults. Several symptom clusters were identified as being related with moderate to strong positive correlations. Furthermore, elevations on the Impulse subscale were noted to be the most prevalent in the current sample, with comorbid elevations most commonly occurring along the Mood, Mania, and Anxiety subscales. The significance of these findings is discussed.