Assessment of the relationship between diagnoses of ASD and caregiver symptom endorsement in adults diagnosed with intellectual disability.

Individuals diagnosed with an intellectual disability (ID) share overlapping traits with those diagnosed with both ID and an Autism Spectrum Disorder (ASD). Therefore, the purpose of this study was to determine if caregivers' reports of symptoms of ASD are of value (i.e., when comparing them to clinical diagnoses of ASD) and to determine which symptoms of ASD best differentiate those with ASD from those with ID only. It was hypothesized that a subset of items would emerge using the Autism Spectrum Disorders-Diagnostic for Adults (ASD-DA) which would differentiate the two groups utilize in this study. One hundred eighty-six adults diagnosed with ID with and without diagnosis of ASD were assessed for core symptoms and other behavioral differences using the ASD-DA. Most of the individuals in the ID group (n = 93) and the ID plus ASD group (n = 93) were in the profound range of ID. The items which were most likely to distinguish individuals with ASD were in socialization domain. Furthermore, adults with ASD were more likely to be male and to be non-verbal.

Effects of symptoms of co-morbid psychopathology on challenging behaviours among infants and toddlers with Autistic Disorder and PDD-NOS as assessed with the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT).

PURPOSE: To examine whether level of symptoms of co-morbid psychopathology exacerbated challenging behaviours in young children with autism spectrum disorders (ASD). METHOD: Using the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT)-Part 2 which measures co-morbid symptoms and the BISCUIT- Part 3 which examines challenging behaviours, 362 infants and toddlers with ASD were evaluated. RESULTS: Findings showed that participants scoring high on symptoms of Avoidance and Tantrum/Conduct problems had greater rates of aggressive/destructive behaviours, self-injurious behaviours (SIB) and stereotypies compared to those with low scores. Participants with high levels of Inattention/Impulsivity or Eat/Sleep concerns, compared to those with low levels, demonstrated greater aggressive/destructive behaviour and stereotypies. For symptoms of Anxiety/Repetitive Behaviours, participants with high scores displayed greater levels of stereotypies. CONCLUSIONS: Symptoms of co-morbid psychopathology are present at a very early age for children with ASD and elevated levels of these symptoms may exacerbate challenging behaviours.

Stability of symptoms of autism spectrum disorders in toddlers: an examination using the Baby and Infant Screen for Children with aUtIsm Traits-Part 1 (BISCUIT).

OBJECTIVE: The diagnostic stability of Autism Spectrum Disorders (ASD) at very young ages continues to be debated, despite empirical evidence that ASDs can be reliably diagnosed in children under the age of 3 years. This topic is of the upmost importance given that early intervention increases long-term outcomes in this population. METHODS: The goal of the current study was to examine the stability of symptoms of ASD between two assessment times for 114 toddlers. The following was compared from the first to second assessment: diagnostic classification stability, correlations between scores and the impact of time between the first and second assessment. RESULTS: Significant correlations were found for toddlers as young as 18 months of age. In addition, even with up to a year between assessment intervals, symptoms of ASD were relatively stable prior to 3 years of age. CONCLUSIONS: Implications of the current findings are discussed.

The effects of inattention/impulsivity and ASD symptom severity on social skills in toddlers.

OBJECTIVE: The aim of the current study was to examine the effects of symptom severity of ASD and symptom severity of inattention and impulsivity in toddlers to determine the potential impact on social skills. METHODS: A total of 240 toddlers diagnosed with ASD, ranging in age from 17-36 months, were included in this study. Parents or legal guardians were administered measures assessing for symptoms of ASD, symptoms of psychopathology and social skills. RESULTS: A significant interaction was found, indicating that toddlers with less severe symptoms of ASD and of inattention/impulsivity had better social skills. In contrast, toddlers with more severe symptoms of ASD and inattention/impulsivity had the most deficits in social skills. CONCLUSION: These results further confirm that a multidimensional approach to assessment is needed and that comorbid psychopathology symptoms and social skills targets should be a focus of assessment and intervention.

Reliability and validity of the Matson Evaluation of Social Skills with Youngsters.

Social skills are an important part of development, and deficits in this area have long-term impacts on a child. As a result, clinicians should include a measure of social skills as part of a comprehensive assessment. There are a few well-researched measures of social skills that are currently used, including the Matson Evaluation of Social Skills with Youngsters (MESSY). The MESSY has been translated and studied internationally in more than nine countries; however, updated norms for the United States have not been conducted since the inception of the measure. The purpose of this article is to examine the psychometric properties of the MESSY using an updated norm sample and age cohorts. Overall results indicated strong internal consistency and good to strong convergent and divergent validity. Psychometric properties for the older age cohorts were stronger and more consistent than those for the 2- to 5-year-olds. This reflects the variability of development and difficulty of assessing social skills at this young age.

The effect of seizure disorder on symptom presentation in atypically developing children and children with autism spectrum disorders based on the BDI-2.

PURPOSE: Autism Spectrum Disorders (ASD) and seizures are highly comorbid conditions. However, little research has been done to examine this relationship. The purpose of the current study was to examine the effect that seizure disorder has on symptom presentation in children with autism spectrum disorders as compared to atypically developing children. METHOD: The Battelle Developmental Inventory, Second Edition (BDI-2) was used as a measure of impairment across adaptive, personal-social, communication, motor and cognitive skills. RESULTS: A MANOVA indicated significant main effects between diagnostic group and seizure status, without a significant interaction. Follow-up univariate tests were conducted. CONCLUSIONS: Overall, results indicated that children with ASD were more impaired than atypically developing children. In addition, children with seizures tended to be more impaired than children without seizures.

Developmental milestones in toddlers with autistic disorder, pervasive developmental disorder--not otherwise specified and atypical development.

OBJECTIVE: To investigate age differences in developmental milestone attainment among toddlers with Autistic Disorder, PDD-NOS and atypical development. METHODS: A questionnaire was administered to caregivers of toddlers to obtain ages of onset of developmental milestones. The study included 1044 participants with 442, 112, 498 and 497 participants in first word, first phrase, crawling and walking analyses, respectively. RESULTS: Significant differences were found between groups on the attainment of milestones within normal limits, delayed or not yet attained. Significant differences were also found between groups in age of saying first word and onset of crawling. There were no significant differences between groups for walking or first phrase. CONCLUSION: Increased severity of autism has been noted to be related to greater deficits in a multitude of areas. With basic human motor behaviours also appearing to follow that trend, motor and speech skills should be targeted in early intervention programmes.

Antipsychotic drug side effects for persons with intellectual disability.

Antipsychotic drugs are the most frequently prescribed of the psychotropic drugs among the intellectually disabled (ID) population. Given their widespread use, efforts to systematically assess and report side effects are warranted. Specific scaling methods such as the Matson Evaluation of Side Effects (MEDS), the Abnormal Inventory Movement Scale (AIMS), and Dyskinesia Identification System Condensed User Scale (DISCUS) are reviewed. Symptom patterns and a focus on additional research are discussed. While progress has been made, more and more systematic methods to research these problems are necessary.

An Examination of Psychotropic Medication Side Effects: does taking a greater number of psychotropic medications from different classes affect presentation of side effects in adults with ID?

This study examined whether the number of psychotropic medications an individual is taking across classes influences side effects among adults with Intellectual Disability (ID). Participants were 80 adults diagnosed with ID. Dependent variables were the composite score and domain scores of the Matson Evaluation of Drug Side-effects (MEDS), which is an instrument used to assess side effects. There were three levels of the independent variable: Group 1--those taking zero psychotropic medications, Group 2--those taking one psychotropic medication, and Group 3--those taking two psychotropic medications across different medication classes. There was a significant main effect regarding number of psychotropic medication classes prescribed. Further analysis revealed that four of the nine MEDS domains had significantly different mean scores for number of psychotropic medication classes. For the majority of MEDS domains, such as Central Nervous System-General, Parkinsonism/Dyskinesia, and Behavioral/Akathesia domains, participants in the no psychotropic medication group had significantly lower mean scores than those in the one and two psychotropic medication groups. Only two MEDS domains, Cardiovascular and Hematologic Effects as well as Skin, Allergies, and Temperature, were significantly different between participants taking one psychotropic medication as compared with two psychotropic medications from different classes. Implications of these findings and recommendations for future research are discussed.

Tardive dyskinesia and intellectual disability: an examination of demographics and topography in adults with dual diagnosis and atypical antipsychotic use.

Atypical antipsychotic medications are commonly used in large-scale residential care facilities for adults with developmental disabilities. While the benefits of this class of psychotropics are noted, debate exists whether the side effect profile of these medications outweigh their therapeutic benefit, especially in those who use them long-term. Tardive Dyskinesia (TD) is a movement disorder often caused by a history of neuroleptic use which can cause deleterious effects. Due to the seriousness of TD and the impact on an individual's quality of life, it is necessary to identify predisposing factors for this condition in a population of adults with intellectual and developmental disabilities. The current study seeks to expand the literature related to TD and atypical antipsychotic medication utilizing a measure of medication side effects, the Matson Evaluation of Drug Side Effects (MEDS). Results and implications for assessment and practice are discussed.

Cut-offs, norms and patterns of problem behaviours in children with developmental disabilities on the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT-Part 3).

PURPOSE: Challenging behaviours present major impediments to a young child's life. Being able to properly assess these behaviours can lead to early intervention and remediation. METHOD: In the present study, the problem behaviours of 644 children 17-37 months of age who were at risk for developmental disabilities were studied using the BISCUIT-Part 3. In study one, norms and cut-off scores were established for this new scale using this sample. In study 2, the frequency and patterns of various challenging behaviours were evaluated. RESULTS: The majority of developmentally delayed children who had severe challenging behaviours engaged in aggressive/destructive acts. However, severe problem behaviours were in the minority of occurrence. CONCLUSIONS: Outcomes suggest that these behaviours can be identified at an early age using a validated instrument tool. Implications are that pinpointing emerging problematic behaviours allows for a more accurate assessment of the delayed child's overall functioning. Being able to pinpoint behaviour problems allows for earlier and more effective treatment.

Effect of developmental quotient on symptoms of inattention and impulsivity among toddlers with Autism Spectrum Disorders.

The effect of developmental quotient on symptoms of inattention and impulsivity was examined among 198 toddlers with Autism Spectrum Disorders. There were two levels of developmental quotient: (1) low (less than or equal to 70; n=80), and (2) typical (greater than 70; n=118). Symptoms of inattention and impulsivity were assessed using 14 items that comprise the BISCIUT-Part 2 inattention/impulsivity subscale. There was no significant effect of developmental quotient on these items representing inattention and impulsivity when severity of Autism Spectrum Disorder symptoms was controlled for. However, the covariate, severity of Autism Spectrum Disorder symptoms, was significantly related to 12 of the 14 items. Percent endorsement of impairment of symptoms relating to inattention and impulsivity for the low and typical developmental quotient groups is also listed. Implications of the results are also discussed.

Cutoffs, norms, and patterns of comorbid difficulties in children with developmental disabilities on the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT-Part 2).

Behavioral symptoms of comorbid psychopathology of 651 children 17-37 months of age who were at risk for developmental disabilities were studied using the BISCUIT-Part 2. In Study 1, norms and cutoff scores were established for this new scale on this sample. In Study 2, frequency of response on the 52 items measured was reported. Problems in eating and sleep were the most common with just over 15% of the sample experiencing these difficulties of either a moderate or severe nature. For severe problems, the most commonly reported difficulties were inattention/impulsivity, and tantrums/conduct behavior problems. Implications of this scale and these data for early identification of behavior disorders in atypically developing children are discussed.

Parent training: a review of methods for children with developmental disabilities.

Great strides have been made in the development of skills and procedures to aid children with developmental disabilities to establish maximum independence and quality of life. Paramount among the treatment methods that have empirical support are treatments based on applied behavior analysis. These methods are often very labor intensive. Thus, parent involvement in treatment implementation is advisable. A substantial literature on parent training for children has therefore emerged. This article reviews recent advances and current trends with respect to this topic.