Dyskinesias differentiate autistic disorder from catatonia.

Autistic disorder and catatonia are neuropsychiatric syndromes defined by impairments in social interaction, communication, and restricted, stereotypical motor routines. Assessments of children with these disorders are typically restricted in scope by the patients' limited ability to comprehend directions. The authors performed systematic assessments of dyskinesias on six prepubertal boys with autistic disorder and mental retardation and on one adolescent male with catatonia to determine if this type of information could be routinely obtained. The boys with autistic disorder had more stereotypies and tics, a greater degree of akathisia and hyperactivity, and more compulsions than the adolescent with catatonia. Catatonia was associated with catalepsy and dystonic postures. The authors conclude that the diagnostic accuracy and specificity of neuropsychiatric syndromes may be enhanced by the systematic assessment of the dyskinesias associated with each condition.

A review of the literature and a preliminary study of family compliance in a developmental disabilities clinic.

To investigate the compliance of family members with the treatment recommended for patients, three child and adolescent psychiatrists assessed the charts of all active outpatients in a developmental disabilities clinic in the psychiatric department of a tertiary care municipal hospital utilizing a Family Compliance Checklist, a survey form for chart review, in October, 1993 (n = 40), and in April, 1994 (n = 41). Almost no clients missed appointments over a 6-mo. period. Only one family refused to permit the use of medication. Three families refused to make appointments. The majority of the patients were Hispanic and almost half were Roman Catholic. We conclude that most families of patients in a developmental disabilities clinic comply with recommended treatment plans including scheduled appointments and prescribed medications.

Clinical assessment of self-injurious behavior.

The Timed Self-injurious Behavior Scale is an observational scale rating the frequency of 16 types of self-injurious behaviors during each 10-sec. interval of a 10-min. observation period. Advantages of the scale are utilization of direct observation and independence from the variable recollection of symptoms by subjects and care givers. 19 videotaped sessions of a subject who exhibited eight types of self-injurious behaviors were rated with the scale independently by three raters. Eighty percent and better agreement was found for the four specific forms of those behaviors exhibited by the subject sufficiently frequently, self biting, head punching, head slapping, and hair removal.