Max Horovitz

DSM-IV vs DSM-5 diagnostic criteria for toddlers with autism.

Purpose: To evaluate prevalence rates of autism and autism symptomatology in toddlers using DSM-IV vs DSM-5 criteria. Method: Two thousand seven hundred and twenty-one toddlers at risk for a developmental disability participated. DSM-IV and DSM-5 criteria were applied and overall prevalence using each set of criteria was established. Groups were also compared on BISCUIT-Part 1 scores to determine if groups differed on autism symptomatology. Results: DSM-5 resulted in 47.79% fewer toddlers being diagnosed with ASD compared to those on the DSM-IV. Toddlers diagnosed according to DSM-5 exhibited greater levels of autism symptomatology than those diagnosed with DSM-IV, but the latter group still exhibited significant levels of autism symptomatology. Conclusion: The proposed DSM-5 will result in far fewer persons being diagnosed with ASD. These results replicate findings from two previous studies, with older children/adolescents and adults. As a result of these new criteria, far fewer people will qualify for needed autism services.

Communication deficits in babies and infants with autism and pervasive developmental disorder-not otherwise specified (PDD-NOS)

Objective: To investigate if, and in what ways, communication impairments are present in toddlers (17–37 months) diagnosed with autism and Pervasive Developmental Disorder–Not Otherwise Specified (PDD-NOS). Methods: Study 1—The scores of 20 toddlers with autism or PDD-NOS (i.e. ASD group) were compared to those of 20 typically-developing infants on the Communication sub-scale of the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT)–Part 1. Study 2—These same scores were compared between 660 toddlers who fell into three groups: autism, PDD-NOS and non-ASD-related developmentally delayed. Results: Infants with an ASD exhibited greater communication impairments than did typically-developing infants overall and on all items. Additionally, significant differences were found in overall communication impairments and the majority of individual items between all three groups in Study 2. Conclusions: Significant communication impairments are present in toddlers diagnosed with autism and PDD-NOS before 37 months.

Parents’ first concerns of their child's development in toddlers with autism spectrum disorders

Objective: Investigations about first concerns among parents of toddlers with ASD and comparisons of the same with children diagnosed with other developmental disorders are scarce. Method: The current study utilized a sample of toddlers diagnosed with an ASD or other developmental delay and examined the nature of parents’ first concern and the age of first concern compared to the age of first assessment. Results: The majority of parents of both toddlers diagnosed with ASD and non-ASD related developmental delays indicated that the area of first concern was in communication. However, the age of first concern was significantly younger for toddlers with an ASD diagnosis. In addition, there was a significant positive correlation between the age at which concerns were first noted and the age at which assessment was sought. Conclusion: The implications of these findings are discussed as they relate to early assessment and intervention.

The Effects of Gender and Age on Repetitive and/or Restricted Behaviors and Interests in Adults with Autism Spectrum Disorders and Intellectual Disability.

Frequency of repetitive and/or restricted behaviors and interests (RRBIs) was assessed in 140 adults with autism spectrum disorders (ASDs) and severe or profound intellectual disability (ID). The associations of gender and age range were analyzed with RRBI frequency which was obtained using the Stereotypies subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II). A significant main effect of gender was found. Male participants had higher frequency of RRBIs than females regardless of age range. There was not a significant main effect of age range or a significant interaction between gender and age range. Results and implications are discussed.

What Is the Evidence for Environmental Causes of Challenging Behaviors in Persons with Intellectual Disabilities and Autism Spectrum Disorders

An extensive literature on the causes of challenging behaviors has been developed, primarily in the applied behavior analysis literature. One hundred and seventy-three empirical studies were reviewed where functional assessment serves as the primary method of identifying these causes. Most of the studies were able to identify a clear function or functions. Most commonly established causes were attention, the efforts to acquire tangibles, negative reinforcement in the form of escape from tasks or environments, and sensory stimulation, also described as an alone condition. Examples are provided regarding how these conditions are investigated across studies. Biological and cognitive causes have also been demonstrated. However, to date the empirical literature is limited with the bulk of studies being correlational. Considerably more research is needed, but some causes and methods to identify them are beginning to emerge.

Incidence and trends in psychopathology symptoms over time in adults with severe to profound intellectual disability

Individuals with intellectual disability (ID) have a high risk for developing comorbid psychopathology. While researchers have shown that symptoms of psychopathology remain relatively stable in children with ID over time, little research has been conducted to demonstrate symptom stability for adults with ID. Incidence of psychopathology symptoms was examined in 124 adults with severe to profound ID. Then, trends in symptoms of psychopathology over time were studied in 74 of those individuals who had data collected quarterly over the span of one year. Data from the Diagnostic Assessment for the Severely Handicapped-Second Edition (DASH-II) were evaluated for each of the 13 subscales, as well as the total DASH-II score. For all of the scales except PDD/Autism, symptoms did not fluctuate significantly over the one year period. The PDD/Autism scale revealed a significant change in symptoms from Time 1 to Time 3. The implications of these results are discussed.

The occurrence of challenging behaviours in children with autism spectrum disorders and atypical development

Objective: This study examines the occurrence of challenging behaviours in children with ASDs and atypical development. Design: This study is a descriptive non-experimental design that inspects the frequencies of challenging behaviours among two diagnostic groups. This type of methodology is important since research in this area is still in the beginning stages of development. Methods: The sample consisted of 2131 children, with 633 having an ASD and 1498 having atypical development. The Baby and Infant Screen for Children with aUtIsm Traits-Part 3 (BISCUIT-Part 3) assesses problematic behaviours within this population. The frequencies of challenging behaviours were examined along with an inspection of the co-occurring items. Results: Greater percentages of problematic behaviours were found in the ASD group as compared to the group with atypical development. Conclusion: Challenging behaviours are variables affecting the behavioural presentation of those with ASDs and may be considered into the treatment plans for these children.

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.

Cross-cultural differences in comorbid symptoms of children with autism spectrum disorders: An international examination between Israel, South Korea, the United Kingdom and the United States of America

Objective: To examine the relationship between culture and symptoms of comorbid psychopathology in those with autism spectrum disorders (ASD). Design: Multivariate analyses of variance (MANOVAs) for each country and each sub-scale of the Autism Spectrum Disorders-Comorbid for Children (ASD-CC). Follow-up independent univariate analyses and post-hoc tests as needed. Methods: Separate samples from South Korea, the UK and Israel were compared to a sample from the US in order to examine cultural contributions, using the ASD-CC. Results: Overall, few differences were found. Significantly, the US had significantly higher scores than South Korea on the avoidant sub-scale. Additionally, the US had significantly higher scores than Israel on the over-eating and tantrum sub-scales. No significant differences were found between the US and the UK. Conclusion: Cultural factors, such as views of typical behaviour, should be taken into account when examining symptoms of comorbidity in children with ASD.

Behaviors and corresponding functions addressed via functional assessment

One-hundred seventy-three studies that employed functional assessment were evaluated with respect to types of challenging behaviors studied and the functions identified that maintained those behaviors. For most studies, two to three behaviors were targeted. Of the 38 different challenging behaviors identified, self-injurious behavior (SIB) and aggression were by far the most studied. Other commonly studied behaviors were tantrums, stereotypies, property destruction, bizarre/inappropriate speech/vocalizations, and disruptive behaviors. The most commonly identified functions for both SIB and aggressions were attention and escape/demands. The implications of these and other data complied on target behaviors and maintaining variables are discussed.