[Girls with subtle autism presentation; case reports]. / Meisjes met een subtieler autismebeeld; casusbeschrijvingen.

BACKGROUND: Autism is often missed in girls. Their problems may appear more subtle, but their suffering is not less. AIM: To describe the diagnostic picture of autistic girls. METHOD: Using retrospective file research, the autism behavioral descriptions of 17 girls aged three to ten were reported. RESULTS: There were deficits on the same autism core domains. Girls often had a strong adaptability, and as a result their limitations were expressed differently in different settings. CONCLUSION: For clinicians, it is important to look beyond the technical level of social skills, by more in-depth questioning and by paying attention to the quality of these skills. Clinical expertise in this area is important.

Better theory-of-mind skills in children hearing voices mitigate the risk of secondary delusion formation.

OBJECTIVE: To examine the social cognitive vulnerabilities mediating delusion formation in children presenting with hallucinatory experiences. METHOD: A sample of 259 12- and 13-year-old children, from a baseline case-control sample of children with and without auditory hallucinations (AH), were re-assessed after 5 years for presence of AH. Presence of delusions and theory of mind (ToM) were also assessed, to examine the hypothesized moderating role of ToM in delusion formation in children hearing voices. RESULTS: In children with AH at age 7-8 and/or 12-13 years, the risk of delusion formation was significantly higher (P interaction = 0.027) in those with lower ToM skills (OR = 4.3, 95% CI 1.9-9.9, P = 0.000), compared to those with higher ToM skills (OR 1.6, 95% CI 0.7-3.7, P = 0.26), independently from secondary school level. CONCLUSION: The results suggest that better mentalizing abilities confer protection against delusion formation in children experiencing perceptual anomalies, not reducible to general cognitive ability.

The Predictive Value of the AQ and the SRS-A in the Diagnosis of ASD in Adults in Clinical Practice.

Questionnaires are widely used in autism assessment. However, their psychometric properties are generally not evaluated in clinical practice, and the comparability and applicability of such research is limited because questionnaires are often not simultaneously evaluated. This certainly pertains to predictive values which are highly population and setting specific. This study evaluated the power of AQ and SRS-A in predicting an ASD diagnosis within the same clinical population. The patient records of 92 adults, referred for autism assessment, were analyzed. The AQ proved somewhat better than the SRS-A at discriminating and predicting autism. The predictive values of both questionnaires were lower than reported in general population studies. Psychometric results in core publications appear less representative for clinical practice.

Detecting Feeding Problems in Young Children with Autism Spectrum Disorder.

Feeding problems are prevalent in children with ASD. We investigated whether the Montreal Children's Hospital Feeding Scale (MCH-FS, Ramsay et al. in Pediatrics and Child Health 16:147-151, 2011) can be used for young children with ASD. Participants (1-6 years) were selected from a clinical ASD sample (n = 80) and a general population sample (n = 1389). Internal consistency was good in both samples. In general, parents of children with ASD reported more feeding problems than those from the population sample. The response patterns on the individual items was highly similar. There was a slight increase in symptoms with age in the population sample, but not in the ASD sample. These results suggest that the MCH-FS can be used in populations that include children with ASD.

Measuring theory of mind in children. Psychometric properties of the ToM Storybooks.

Although research on Theory-of-Mind (ToM) is often based on single task measurements, more comprehensive instruments result in a better understanding of ToM development. The ToM Storybooks is a new instrument measuring basic ToM-functioning and associated aspects. There are 34 tasks, tapping various emotions, beliefs, desires and mental-physical distinctions. Four studies on the validity and reliability of the test are presented, in typically developing children (n = 324, 3-12 years) and children with PDD-NOS (n = 30). The ToM Storybooks have good psychometric qualities. A component analysis reveals five components corresponding with the underlying theoretical constructs. The internal consistency, test-retest reliability, inter-rater reliability, construct validity and convergent validity are good. The ToM Storybooks can be used in research as well as in clinical settings.

Executive functioning in children with ASD: an analysis of the BRIEF.

The Behavior Rating Inventory of Executive Functions (BRIEF) screens for executive function deficits in 5- to 18-year-olds. Data of three autism subgroups, according to DSM-IV-TR criteria (N = 35 Autistic Disorder, N = 27 Asperger's Disorder and N = 65 PDD-NOS), were analyzed. The total group has elevated scores on almost all BRIEF scales. The Shift scale is clinically elevated, reflecting a deficit in cognitive flexibility. The BRIEF scales are not found to discriminate among the autism spectrum disorder (ASD) subgroups. The relation between BRIEF and IQ is complex. Possible influencing factors are discussed. Finally, it is recommended to omit the Negativity scale as a validity index in children with ASD and to consider a high score on this index as a unique characteristic of their BRIEF profile, reflecting rigidity problems.