Developmental Profile and Diagnoses in Children Presenting with Motor Stereotypies.

INTRODUCTION: Motor stereotypies represent a typical example of the difficulty in distinguishing non-clinical behaviors (physiological and transient) from symptoms or among different disorders ["primary stereotypies," associated with autistic spectrum disorder (ASD), intellectual disabilities, genetic syndromes, and sensory impairment]. The aim of this study was to obtain an accurate assessment on the relationship between stereotypies and neurodevelopmental disorders. METHODS: We studied 23 children (3 girls), aged 36-95 months, who requested a consultation due to the persistence or increased severity of motor stereotypies. None of the patients had a previous diagnosis of ASD. The assessment included the Motor Severity Stereotypy Scale (MSSS), the Repetitive Behavior Scale-Revised (RBS-R), the Raven's Colored Progressive Matrices, the Child Behavior CheckList for ages 1½-5 or 4-18 (CBCL), the Social Responsiveness Scale (SRS), and the Autism Diagnostic Observation Schedule-second edition (ADOS 2). RESULTS: All patients were showing motor stereotypies for periods of time varying from 6 to 77 months. The MSSS showed that each child had a limited number of stereotypies; their frequency and intensity were mild. The interference of stereotypies was variable; the impairment in daily life was mild. The RBS-R scores were positive for the subscale of "stereotypic behaviors" in all children. Moreover, several children presented other repetitive behaviors, mainly "ritualistic behavior" and "sameness behavior." All patients showed a normal cognitive level. The CBCL evidenced behavioral problems in 22% of the children: internalizing problems, attention, and withdrawn were the main complaints. On the SRS, all but one of the tested patients obtained clinical scores in the clinical range for at least one area. On the ADOS 2, 4 patients obtained scores indicating a moderate level of ASD symptoms, 4 had a mild level, and 15 showed no or minimal signs of ASD. DISCUSSION: Motor stereotypies in children with normal cognitive level represent a challenging diagnostic issue for which a finely tailored assessment is mandatory in order to define a precise developmental profile. Thus, careful and cautious use of standardized tests is warranted to avoid misdiagnosis. Furthermore, it is hard to consider motor stereotypies, even the primary ones, exclusively as a movement disorder.

Effect of the concentration and composition on the size and shape of micelles of sodium oleate-cetyltrimethylammonium bromide mixtures.

The dependence of the aggregation number (N(agg)) on composition and concentration of sodium oleate-cetyltrimethylammonium bromide mixed micelles as revealed by cyclic voltammetry experiments shows a complex relationship with the total concentration and the composition of surfactant mixtures. This behavior is related to the evolution with composition of the HLB values and with the composition and the excess free energy of mixed micellization, and is explained by the inclusion of the double bonds of oleate chains in the micellar Stern layers. The increase in size probably leads to a reduction of the micelle surface available for the polar headgroups, causing a reduction in the proportion of double bonds in the hydrocarbon-water interface and a change in the mixed micelle composition. Therefore, the generally held supposition that the composition of mixed micelles does not change with concentration seems rather unrealistic.

An investigation of sleep characteristics, EEG abnormalities and epilepsy in developmentally regressed and non-regressed children with autism.

This study investigated sleep of children with autism and developmental regression and the possible relationship with epilepsy and epileptiform abnormalities. Participants were 104 children with autism (70 non-regressed, 34 regressed) and 162 typically developing children (TD). Results suggested that the regressed group had higher incidence of circadian rhythm disorders than non-regressed children. The regressed group showed higher Children's Sleep Habits Questionnaire Bedtime Resistance, Sleep Onset Delay, Sleep Duration and Night-Wakings scores. Epilepsy and frequent epileptiform EEG abnormalities were more frequent in regressed children. Past sleep disorders and a history of developmental regression were significantly associated with sleep disorders. This study is an initial step in better understanding sleep problems in regressed children with autism, further studies are necessary to better investigate these aspects.