Julie A. Hess

Factor structure and diagnostic fidelity of the Baby and Infant Screen for Children with aUtIsm Traits–Part 1 (BISCUIT–part 1)

Objective: Due to the effectiveness of early intervention on the outcome of individuals with ASD, there is a race to identify children with ASD at younger ages. The Baby and Infant Screen for Children with aUtIsm Traits–Part 1 (BISCUIT–Part 1) is a new assessment tool designed to assess symptoms of ASD in children between the ages of 17–37 months. The aim of this study was to identify the factor structure of BISCUIT–Part 1 and investigate group differences with regards to these factors. Methods: Participants (n = 1287) were enrolled in a state-funded early intervention programme for children at-risk for a developmental disability. The BISCUIT was administered to a parent or other significant caregiver along with other developmental measures as part of the assessment protocol for the early intervention programme. Results: The exploratory factor analysis yielded a three-factor solution consistent with symptom clusters characteristic of ASD. Furthermore, participants diagnosed with ASD exhibited significantly higher scores on the factors of the BISCUIT–Part 1, compared to toddlers without a diagnosis of ASD. Conclusion: The BISCUIT–Part 1 shows promise in aiding clinicians in the diagnosis of ASD in infants and toddlers.

Social and communication behaviours in infants and toddlers with autism and pervasive developmental disorder-not otherwise specified

Purpose: Autism Spectrum Disorders (ASD) are a group of conditions characterized by symptoms that onset in early childhood. Deficits in social skills and communication are two of the core features of ASD and, if not remediated, can lead to poor long-term outcomes. Few researchers have examined characteristics of social skills and communication in infants with ASD. Method: The social skills and communicative ability of 886 infants and toddlers 17–37 months of age with autism, PDD-NOS or ‘at risk’ for other developmental delays were evaluated using the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT). A Kruskal-Wallis test with follow-up Mann-Whitney tests were used to test for significance. Results: Infants and toddlers with autism, followed by PDD-NOS, had greater social and communication deficits than children ‘at risk’ for developmental delays. Items which distinguished between these diagnostic groups were determined. Conclusions: Outcomes suggest that social and communication deficits can be identified at early ages in a population of developmentally delayed toddlers. Implications are that pinpointing emerging social and communicative autistic traits earlier will allow for more accurate assessment and diagnosis in infants with ASD. This translates into earlier intervention and more effective treatment practices.

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.

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 relation of social behaviours and challenging behaviours in infants and toddlers with Autism Spectrum Disorders.

Purpose: Challenging behaviours are a commonly co-occuring problem in children with ASD and are often present during the toddler years. The relationship that these challenging behaviours have with core features of ASD, specifically social behaviours, was examined in this study. Method: This study analysed the relationship between socialization and challenging behaviours among 153 toddlers with autism spectrum disorder. Social behaviour was evaluated using the Battelle Developmental Inventory, 2nd Edition and challenging behaviours were assessed using Baby and Infant Screen for Children with aUtIsm Traits, Part 3. Result: Lower levels of adult interaction and peer interaction were associated with higher levels of stereotypic behaviour, aggressive/destructive behaviour and to a lesser extent self-injury. Conclusions: The nature of the relationships between socialization and challenging behaviours likely interact in several ways. A better understanding of these relationships is essential to early identification and treatment of children with ASD.

The Effect of Communication Deficits on Anxiety Symptoms in Infants and Toddlers With Autism Spectrum Disorders

Autism spectrum disorders (ASDs) are life-long developmental disorders characterized by impairments in the development of reciprocal social and communication skills, abnormal language development, and a restricted repertoire of behaviors and interests. While it has been known for some time that children with ASD can evince elevated rates of anxiety symptoms, little research has been conducted on whether deficits in communication skills affect the range of anxiety symptoms in infants and toddlers with ASD. This study represents a first attempt to determine whether deficits in communication skills have an effect on the expression of anxiety in infants and toddlers with autistic disorder and pervasive developmental disorder-not otherwise specified. Seven hundred thirty-five infants were evaluated with respect to the nature and extent of anxiety symptoms and developmental functioning. Both receptive and expressive communication skills appeared to play a significant role in the manifestation of anxiety symptoms.

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.

Developmental profiles from the Battelle developmental inventory: A comparison of toddlers diagnosed with Down Syndrome, global developmental delay and premature birth

Objective: Developmental profiles and milestone attainment have been examined for children suffering from various developmental disabilities. However, research comparing the same across numerous developmental disabilities is scant. Method: Therefore, the purpose of the current study was to examine the developmental profiles of toddlers (i.e. aged 17–34 months) who were premature, diagnosed with Down Syndrome, or diagnosed with Global Developmental Delay. A total of 28 toddlers met inclusion criteria for the study. Results: Those diagnosed with Global Developmental Delay or Down Syndrome scored significantly lower on the Battelle Developmental Inventory, Second Edition (BDI-2), compared to those who were born premature. More specifically, differences emerged on the BDI-2 domains of personal-social and motor. Conclusion: Implications of these findings and directions 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 individuals 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.

Assessment of toileting difficulties in adults with intellectual disabilities: An examination using the profile of toileting issues (POTI)

A lack of toileting skills is one of many impairments that individuals with intellectual and developmental disabilities experience. Unfortunately, little research has focused on problems in this area including assessment, function, and treatment. A newly developed checklist, the Profile of Toileting Issues (POTI), is being considered for use to screen for toileting issues in this population, and to identify potential functions to target in treatment. The purpose of the current study was to examine the reliability of the POTI. Internal consistency was sound (α = .83) and interrater reliability was significant. The implications of these findings are included.