Nocturnal enuresis and psychosocial problems in pediatric sickle cell disease and sibling controls.

To evaluate current and lifetime prevalence rates of nocturnal enuresis and psychosocial problems among children with sickle cell disease (SCD) in comparison with sibling controls, a structured interview and the Pediatric Symptom Checklist were administered to primary caretakers regarding 126 of their children aged 5 to 17 with SCD and 47 sibling controls. Lifetime rates of enuresis among children with SCD were comparable to similar studies, and exceeded population prevalence and sibling control rates. In addition, enuretic children had higher levels of total psychosocial problems on the Pediatric Symptom Checklist regardless of group status, although patterns of subscale differences varied by group and enuresis history after controlling for child age. These findings replicate and extend previous findings and provide further evidence to support a need for monitoring of hydration levels and screening for psychosocial problems among children with SCD and enuresis, as well as evaluation of the psychometric properties of psychosocial screening measures and identification of efficacious treatments for enuresis in children with SCD.

Clinical case study: pediatric residents' discussions of and interventions for children's behavioral and emotional problems.

OBJECTIVE: To examine the effects of a screening instrument and parent handouts on pediatric residents' discussions of and interventions for children's behavioral and emotional problems. METHOD: Four pediatric residents and 52 parent-child dyads attending an ambulatory pediatric primary care clinic participated in the study. We used a multiple baseline design across residents. We assessed the effect of the interventions by measuring nine target behaviors of the pediatric residents. RESULTS: After being trained to use the screening instrument, residents increased the number and variety of questions they asked regarding behavioral and emotional issues. Residents' attempts at intervention showed small but consistent increases when handouts on behavior management procedures were made available for distribution to parents. CONCLUSIONS: The use of a screening instrument in pediatric primary care shows promise for increasing discussions between residents and parents about children's behavioral and emotional issues. Further research should examine strategies to improve pediatric residents' attempts at intervention for behavioral and emotional problems in children.

Elevated plasma gamma-aminobutyric acid (GABA) levels in autistic youngsters: stimulus for a GABA hypothesis of autism.

BACKGROUND: Autistic Disorder is an early-onset developmental disorder with severe lifelong impact on social functioning, communication, and behavior. There is currently no marker or cure. The pathophysiology and etiology are obscure. Evidence for abnormal gamma-aminobutyric acid (GABA) function in Autistic Disorders is limited. A few case-reports and small studies have reported differences in GABA levels in plasma, platelets, and urine, compared to controls. Further studies on abnormalities of GABA function in Autistic Disorder are warranted. MATERIAL/METHODS: Plasma GABA levels were measured using a new and sensitive technique, based on gas chromatography/mass spectrometry, in a small group of youngsters with Autistic Disorder and Attention-Deficit/Hyperactivity Disorder. Participants were outpatients between ages 5-15, satisfying modern criteria for these disorders. RESULTS: Elevated plasma GABA levels were found in youngsters with Autistic Disorder. Psychotropic medications did not seem to affect plasma GABA levels in this study. Plasma GABA levels decreased with age. CONCLUSIONS: Elevated plasma GABA levels may be a biochemical marker of Autistic Disorder. This study supports the hypothesis that GABAergic mechanisms play a role in the etiology or pathophysiology of Autistic Disorder. However, the hypothesis remains unspecified owing to lack of research. Future studies on the clinical associations of seizure disorders, mood disorders, and catatonia in autistic people may provide the necessary data to formulate a coherent theory of GABA dysfunction in Autistic Disorder. More trials of medication with known or suspected effects on GABA function are warranted.

Do adults with mental retardation show pictorial superiority effects in recall and recognition?

We examined memory for pictures and words in adults with mental retardation and a control group of adults of normal intelligence. During acquisition, sets of simple line drawings and matching words were presented for study using an intentional learning procedure. The principle dependent measures were free recall and recognition. Measures of working memory span were also administered. Pictorial superiority effects occurred in free recall and recognition for both intelligence-level groups. Correlational analyses indicated that working memory span was primarily related to recall performance, irrespective of stimulus format. These data strongly suggest that persons with mental retardation can utilize nonverbal memory codes to support long-term retention as effectively as do adults of normal intelligence.