Using the five to fifteen-collateral informant questionnaire for retrospective assessment of childhood symptoms in adults with and without autism or ADHD.

Due to lack of previous studies, we aimed at evaluating the use of the Five to Fifteen (FTF) questionnaire in adults with neurodevelopmental disorders (NDD) and in controls without NDD. The NDD group consisted of adults with autism spectrum disorder ASD (n = 183) or attention-deficit/hyperactivity disorder (ADHD) (n = 174) without intellectual disability, recruited from a tertiary outpatient clinic. A web survey was used to collect data from general population adult control group without NDD (n = 738). The participants were retrospectively rated by their parents regarding childhood symptoms, using five to fifteen-collateral informant questionnaire (FTF-CIQ). Adults with NDD had higher FTF-CIQ domain and subdomain scores than controls, and displayed similar test profiles as children with corresponding diagnosis in previous studies. Based on the FTF-CIQ domain scores, 84.2% of the study participants (93% of the controls; 64% of the adults with NDD) were correctly classified in a logistic regression analysis. Likewise, Receiver Operating Characteristic (ROC) curve analysis on FTF-CIQ total sum score indicated that a cut-off value of 20.50 correctly classified 90% of the controls and 67% of the clinical cases, whilst a cut-off value of 30.50 correctly classified 84% of the controls and 77% of the clinical cases. The factor analysis revealed three underlying components: learning difficulties, cognitive and executive functions; social skills and emotional/behavioural symptoms; as well as motor and perceptual skills. Whilst not designed as a diagnostic instrument, the FTF-CIQ may be useful for providing information on childhood symptoms and associated difficulties in individuals assessed for NDD as adults.

The script model in relation to autism.

The primary purpose of this study was to investigate autistic children's scripts for social routines. Scripts specify familiar events in terms of who does what, when, to whom, and why. Scripts are verbalizations of mental event representations, containing and organizing generalized knowledge of how the world works. Scripts are presumed to be of vital importance for the development of shared meaning, communication, and social behaviour. In this study, children with autism were asked to explain well-known social routines, such as how you shop in a supermarket, make a cake or celebrate a birthday. The scripts of the 12 children with non-retarded autism were compared to scripts of matched normal control children. Despite the fact that all of the participating children with autism had an IQ above 90 and a mental age between 8 and 14, a significant difference in autistic and normal control children's ability to generate scripts for familiar social routines was found. The results are discussed in relation to the same children's ability to pass theory-of-mind tests and their verbal intelligence.

Theory of mind in non-retarded children with autism and Asperger's syndrome. A research note.

In the present study, 20 non-retarded children with autism and 20 non-retarded children with Asperger's syndrome, individually matched to the group of children with autism, participated. No statistically significant differences between the groups were found in the theory of mind tasks. In fact, the two groups performed almost as well as a group of normal children. These findings suggest that the theory of mind model has its limitations in explaining autism and that children with Asperger's syndrome are not more competent in theory of mind tasks than children with autism within the normal range of intelligence.

Early lead exposure and neonatal jaundice: relation to neurobehavioral performance at 15 years of age.

A cohort of children who attended first grade in 1983 was identified in a Danish community with low-level lead pollution. Two groups with high and low postnatal lead exposure were generated on the basis of the dentin-lead concentration in shed deciduous incisors. At age 8 years, examination of 162 children matched according to gender and socioeconomic status had shown lead-related deficits in verbal intelligence and visuomotor coordination. Re-examination was now carried out in 141 children at age 15 years using the Wechsler Intelligence Scale for Children (WISC), Bender Visual Motor Gestalt, Trail Making, and Visual Gestalts. In general, no lead-related effects could be detected in the group. However, in children with a history of neonatal jaundice, increased lead exposure was associated with mild neurobehavioral deficits, as indicated by lower verbal IQ scores and decreased visuomotor coordination. This finding suggested that moderate neonatal hyperbilirubinemia may have precipitated an increased sensitivity to subsequent exposure to lead.

Learning disabilities in children: significance of low-level lead-exposure and confounding factors.

The hypothesis that low-level lead absorption is a risk factor for learning disabilities in school children was examined in the municipality of Aarhus, Denmark. During 1982-1983, a total of 1,302 children in the first grade (54% of the eligible population) delivered shed deciduous teeth. The lead concentration in the circumpulpal dentin was used as an indicator of the cumulated lead absorption, and 200 cases (high-lead) and controls (low-lead) were selected, and matched for socioeconomic group and gender. The parents were interviewed regarding the child's development and past medical history. Possible confounders were identified and controlled for in a logistic multivariate model. The influence of lead absorption became statistically significant only after exclusion of the children with proven medical risk factors, thereby the adjusted odds ratio in the weighted analysis was changed from 2.2 to 4.3. Thus, in a Scandinavian low-level lead-polluted area, lead absorption appears to be a risk factor for learning disabilities.

A neuropsychological study of children with elevated dentine lead level: assessment of the effect of lead in different socio-economic groups.

The study was carried out in the municipality of Aarhus, a city of 250,000 inhabitants. The study was designed as a cross-sectional cohort study of school children in first grade in 1982-83. A total of 2,412 children were contacted and asked to submit their shed teeth to the teacher, and 1,291 children delivered at least one usable tooth (response rate, 54 percent). The lead level in circumpulpal dentin showed an average of 10.7 micrograms/g. Eight percent of the children (N = 110) had a lead level above 18.7 micrograms/g and were selected as a "high" lead exposure group. This group was matched by sex and socio-economic status of the parents with control children with a dentin lead level below 5 micrograms/g. Following a detailed interview with the parents, children were excluded from the study if medical risk factors were present. A clinical psychologist, blind to the lead data, administered selected psychometric tests to 162 of the children selected. The high-lead children scored lower on the WISC when compared to low-lead children, especially on the Verbal IQ (p less than 0.001) and Full Scale IQ (p less than 0.01). No significant difference was seen between the high- and low-exposure groups on the Performance IQ and on several experimental tests. Impaired function associated with lead exposure was also found on the Bender Visual Motor Gestalt Test (p less than 0.001) and on a behavioral rating scale (p less than 0.01). These results remained statistically significant even after controlling for socio-economic status and other confounding variables.

Traffic a source of lead exposure in childhood.

Experimental and observational data has long implicated automobile exhaust from leaded petrol as a major source of human lead exposure. The present study evaluates the association of individual traffic exposure with individual lead absorption. A case-referent study was carried out on 1302 out of 2412 children in the municipality of Aarhus - Denmark. Shed deciduous teeth were matched for sex and socioeconomic status. Individual lead sources were assessed by an interview. Information on former addresses and the data of address change was obtained as was information on the daily number of cars driving on all roads of the city. A traffic index was constructed describing the traffic density at the home. An association between high lead and high traffic density was found in the children at the age of 6 months to 2 years. This relationship was of a dose-response nature. The association was not account for by other possible major sources.