26
|
Yirmiya N, Sigman M, Freeman BJ. Comparison between diagnostic instruments for identifying high-functioning children with autism. J Autism Dev Disord 1994; 24:281-91. [PMID: 8050982 DOI: 10.1007/bf02172227] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Two instruments for identifying autism in children and adolescents with intellectual abilities in the normal range were compared. Diagnostic tools consisted of the Autism Behavior Checklist (ABC) and the Autism Diagnostic Interview (ADI). The sample was composed of 18 children who were all diagnosed as having either infantile autism or infantile autism, residual state based on DSM-III criteria by a clinical team using observations, parental interviews, and interactions with the children. Only 4 of the children met diagnostic cutoffs for autism on the current ABC but all met criteria for diagnosis on the ABC using parental recall of the child's behavior at 3-5 years of age. The ADI had somewhat greater specificity in that 3 children did not meet criteria for diagnosis although 2 of these children also received ABC scores based on parental recollection that were in the borderline range.
Collapse
|
27
|
Kaler SR, Freeman BJ. Analysis of environmental deprivation: cognitive and social development in Romanian orphans. J Child Psychol Psychiatry 1994; 35:769-81. [PMID: 7518826 DOI: 10.1111/j.1469-7610.1994.tb01220.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The cognitive and social developmental status of a representative group of Romanian orphans between the ages of 23 and 50 months living in the Leagan de Copii in Timisoara, Romania was assessed using a variety of traditional and nontraditional measures. Results indicated that the orphanage sample all exhibited deficits in cognitive and social functioning; the majority were severely delayed. Correlations between the traditional and nontraditional measures indicated that children's delays occurred across domains. Deficits were not related to length of time in the orphanage, age at entrance, Apgar scores, or birthweight. The children's greatest capability was in peer social interaction.
Collapse
|
28
|
Abstract
Clinical descriptions of 14 adults with mild autism are presented. Structured questionnaires, extensive medical and social histories, and mental status examinations were conducted independently by several clinicians who concurred with the diagnoses of autism. These 14 patients demonstrate (1) that mild forms of autism can remain undiagnosed into adulthood; (2) that developmental histories and patients' reports may not provide evidence of developmental delays and characteristic symptoms during childhood despite their presence at adult mental status examination; (3) that mild previously undetected autism should be considered in the differential diagnoses of perplexing adult patients.
Collapse
|
29
|
|
30
|
Freeman BJ. Penetrating chest trauma. J ROY ARMY MED CORPS 1993; 139:75. [PMID: 8355242 DOI: 10.1136/jramc-139-02-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
31
|
Mason-Brothers A, Ritvo ER, Freeman BJ, Jorde LB, Pingree CC, McMahon WM, Jenson WR, Petersen PB, Mo A. The UCLA-University of Utah epidemiologic survey of autism: Recurrent infections. Eur Child Adolesc Psychiatry 1993; 2:79-90. [PMID: 29871451 DOI: 10.1007/bf02098863] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Two hundred and forty-one children with autism were ascertained and diagnosed (DSM-III criteria) in an epidemiologic survey of Utah. Pediatric and other pertinent medical records were abstracted for 233 patients and 66 of their siblings without autism for otitis media, upper respiratory, and other infections. A significantly greater number of children with autism had recurrent otitis media, upper respiratory and other infections than their nonautistic siblings. A greater number of children with autisru with recurrent infections had lower IQ scores, seizures, hearing deficits, delayed motor milestones, poorer speech, congenital anomalies, feeding problems, vomiting, diarrhea, and other types of infections than children with autism with mild or no infections. The only significant pre-, peri-, or postnatal risk factors between children with autism with recurrent, mild or no infection was an increase in the maternal-fetal incompatibility (ABO or Rh) in the recurrent infection group. Half the families with more than one child with autism had recurrent infections and 72% of those children with concurrent diseases which effect the CNS had recurrent infections. Methodological limitations are discussed.
Collapse
|
32
|
Freeman BJ, Westaby S. Repeated ventilatory arrest: consider tracheal tumours. Br J Hosp Med (Lond) 1992; 48:676-7. [PMID: 1458278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
33
|
Mueller FM, Fowler CM, Freeman BJ, Hults WL, King JC, Smith JL. Mueller et al. reply. PHYSICAL REVIEW LETTERS 1992; 68:3937. [PMID: 10045843 DOI: 10.1103/physrevlett.68.3937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
|
34
|
Jorde LB, Hasstedt SJ, Ritvo ER, Mason-Brothers A, Freeman BJ, Pingree C, McMahon WM, Petersen B, Jenson WR, Mo A. Complex segregation analysis of autism. Am J Hum Genet 1991; 49:932-8. [PMID: 1928098 PMCID: PMC1683259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
A complex segregation analysis of autism in 185 Utah families was carried out using the mixed model. The 209 affected individuals in these families represent nearly complete ascertainment of the autistic cases born in Utah between 1965 and 1984. The sibling recurrence risk for autism was 4.5% (95% confidence limits 2.8%-6.2%). Likelihoods were maximized for major-gene models, a polygenic model, a sibling-effect model, and a mixed model consisting of major-gene and shared-sibling effects. The analysis provided no evidence for major-locus inheritance of autism. Subdivision of the sample according to the probands' IQ levels showed that sibling recurrence risk did not vary consistently with IQ level. A segregation analysis of families in which the proband had an IQ less than 50 also failed to provide evidence for a major locus. However, because of the etiologic heterogeneity of this disorder, genetic analysis of other meaningful subsets of families could prove informative.
Collapse
|
35
|
|
36
|
Freeman BJ, Rahbar B, Ritvo ER, Bice TL, Yokota A, Ritvo R. The stability of cognitive and behavioral parameters in autism: a twelve-year prospective study. J Am Acad Child Adolesc Psychiatry 1991; 30:479-82. [PMID: 2055886 DOI: 10.1097/00004583-199105000-00020] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Sixty-two autistic patients enrolled in a prospective study an average of 12 years ago. Current retesting results are now available on 53 of the original 62 patients (85.5%). Results indicate that 36 (67.9%) achieved scores within their original IQ group. Twelve (22.6%) moved up IQ groups and five (9.4%) moved down. Of particular clinical importance is the observation that Vineland Adaptive Behavior Scores were consistently lower than cognitive scores, and maladaptive behaviors occurred with equal frequency in the high, medium, and low IQ groups. The implications of this new data for understanding the natural history of autism, educational and vocational planning, and future research are discussed.
Collapse
|
37
|
Ritvo ER, Mason-Brothers A, Freeman BJ, Pingree C, Jenson WR, McMahon WM, Petersen PB, Jorde LB, Mo A, Ritvo A. The UCLA-University of Utah epidemiologic survey of autism: the etiologic role of rare diseases. Am J Psychiatry 1990; 147:1614-21. [PMID: 2244638 DOI: 10.1176/ajp.147.12.1614] [Citation(s) in RCA: 84] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Twelve rare diseases known to cause CNS pathology were found in 26 (11%) of 233 autistic probands identified during a recent epidemiologic survey of Utah. These 26 probands had significantly lower mean IQs than the remaining patients (43 versus 60) but similar sex distribution and prevalence of abnormal EEGs and seizures. The rarity and diversity of these 12 diseases make it highly unlikely that they randomly occurred with autism. Their presence in this epidemiologic survey is the most compelling evidence to date to support the hypothesis that different diseases producing different types of CNS pathology can play an etiologic role in autism.
Collapse
|
38
|
Mason-Brothers A, Ritvo ER, Pingree C, Petersen PB, Jenson WR, McMahon WM, Freeman BJ, Jorde LB, Spencer MJ, Mo A. The UCLA-University of Utah epidemiologic survey of autism: prenatal, perinatal, and postnatal factors. Pediatrics 1990; 86:514-9. [PMID: 2216614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
In a recent epidemiologic survey conducted in Utah, 241 autistic patients (DSM-III criteria) were found. Medical records of 233 autistics were surveyed for the presence of 36 potentially pathologic prenatal, perinatal, and postnatal factors. These results were compared with those of an identical survey of 62 of their nonautistic siblings, with the results of four previously published surveys, and with normative data. No potentially pathologic factor or group of factors occurred significantly more frequently among the autistic patients. Also, previous observations of significant differences in the occurrence of certain factors in the histories single vs multiple siblings with autism were not confirmed, with the exception of increased viral-type illness during gestation in single-incidence cases. Thus, the etiology of the brain pathology that characteristically disrupts normal development and produces the syndrome of autism remains obscure. Other data from the epidemiologic survey, however, suggest that the role of genetic factors needs to be explored further.
Collapse
|
39
|
Jorde LB, Mason-Brothers A, Waldmann R, Ritvo ER, Freeman BJ, Pingree C, McMahon WM, Petersen B, Jenson WR, Mo A. The UCLA-University of Utah epidemiologic survey of autism: genealogical analysis of familial aggregation. AMERICAN JOURNAL OF MEDICAL GENETICS 1990; 36:85-8. [PMID: 2333911 DOI: 10.1002/ajmg.1320360116] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
To assess familial aggregation of autism, 86 autistic subjects were linked to the Utah Genealogical Database. Kinship coefficients were estimated for all possible pairs of autistic subjects and then averaged. Fifty replicate sets of matched control subjects (86 members in each set) were drawn randomly from the database, and the average kinship coefficient was computed for all possible pairs of individuals in each set. The average kinship coefficient for the autistic subjects was approximately 1/1,000, while the average kinship coefficients for the 50 control groups ranged from 4/100,000 to 1.6./10,000. These results indicate a strong tendency for autism to cluster in families. When kinship was analyzed by specific degrees of relationship, it was shown that the familial aggregation of autism is confined exclusively to sib pairs and does not extend to more remote degrees of relationship. This finding indicates that a single-gene model is unlikely to account for most cases of autism.
Collapse
|
40
|
Ritvo ER, Jorde LB, Mason-Brothers A, Freeman BJ, Pingree C, Jones MB, McMahon WM, Petersen PB, Jenson WR, Mo A. The UCLA-University of Utah epidemiologic survey of autism: recurrence risk estimates and genetic counseling. Am J Psychiatry 1989; 146:1032-6. [PMID: 2750975 DOI: 10.1176/ajp.146.8.1032] [Citation(s) in RCA: 187] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The authors recently reported, in this journal, an epidemiologic survey of autism in Utah. Twenty (9.7%) of the 207 families ascertained had more than one autistic child. Analyses of these data revealed that autism is 215 times more frequent among the siblings of autistic patients than in the general population. The overall recurrence risk estimate (the chance that each sibling born after an autistic child will develop autism) is 8.6%. If the first autistic child is a male the recurrence risk estimate is 7%, and if a female 14.5%. These new recurrence risk estimates should be made available to all individuals who have autistic children and are interested in family planning.
Collapse
|
41
|
Garber HJ, Ritvo ER, Chiu LC, Griswold VJ, Kashanian A, Freeman BJ, Oldendorf WH. A magnetic resonance imaging study of autism: normal fourth ventricle size and absence of pathology. Am J Psychiatry 1989; 146:532-4. [PMID: 2929757 DOI: 10.1176/ajp.146.4.532] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Magnetic resonance imaging did not diagnose neuropathology in 15 autistic patients. Measurements of the midsagittal area and volume of the fourth ventricle did not differ between these patients and matched control subjects.
Collapse
|
42
|
Freeman BJ, Ritvo ER, Mason-Brothers A, Pingree C, Yokota A, Jenson WR, McMahon WM, Petersen PB, Mo A, Schroth P. Psychometric assessment of first-degree relatives of 62 autistic probands in Utah. Am J Psychiatry 1989; 146:361-4. [PMID: 2919694 DOI: 10.1176/ajp.146.3.361] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The Wechsler Intelligence Scales, Wide Range Achievement Test, and the Shipley-Hartford Test were administered to 122 parents and 153 siblings of 62 autistic probands in Utah. Scores were distributed as expected within the published normative ranges for each scale. Parents' scores correlated with those of their nonautistic children, but neither parents' nor siblings' scores correlated with the IQ level of the autistic probands. These results do not confirm prior reports from England and the United States of a high rate of cognitive and learning problems in the siblings of autistic individuals, nor the aggregation of such problems in the siblings of probands with high or low levels of cognitive function.
Collapse
|
43
|
Ritvo ER, Freeman BJ, Pingree C, Mason-Brothers A, Jorde L, Jenson WR, McMahon WM, Petersen PB, Mo A, Ritvo A. The UCLA-University of Utah epidemiologic survey of autism: prevalence. Am J Psychiatry 1989; 146:194-9. [PMID: 2783539 DOI: 10.1176/ajp.146.2.194] [Citation(s) in RCA: 163] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The authors conducted an epidemiologic survey in Utah using a four-level ascertainment system, blind current diagnostic assessments, and DSM-III criteria. Of 483 individuals ascertained, 241 were diagnosed as having autism. The best estimate for the prevalence rate was 4 per 10,000 population. Autism was not associated with parental education, occupation, racial origin, or religion. Sixty-six percent of the autistic subjects scored below 70 on standardized IQ tests, and females scored proportionately lower than males. Twenty (9.7%) of 207 families had more than one autistic sibling, which supports the authors' previous finding that there may be a familial subtype of autism.
Collapse
|
44
|
Freeman BJ, Ritvo ER, Yokota A, Childs J, Pollard J. WISC-R and Vineland Adaptive Behavior Scale scores in autistic children. J Am Acad Child Adolesc Psychiatry 1988; 27:428-9. [PMID: 3182599 DOI: 10.1097/00004583-198807000-00008] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
45
|
Ritvo E, Brothers AM, Freeman BJ, Pingree C. Eleven possibly autistic parents. J Autism Dev Disord 1988; 18:139-43. [PMID: 3372455 DOI: 10.1007/bf02211824] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
46
|
Geller E, Yuwiler A, Freeman BJ, Ritvo E. Platelet size, number, and serotonin content in blood of autistic, childhood schizophrenic, and normal children. J Autism Dev Disord 1988; 18:119-26. [PMID: 3372453 DOI: 10.1007/bf02211822] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Platelet volumes were measured in 19 autistic, 26 normal, and 6 schizophrenic children with similar blood serotonin concentrations. The groups did not significantly differ in platelet volumes, nor did platelet volumes and blood serotonin concentrations correlate. These results do not support the hypothesis that the hyperserotoninemia in some autistics reflects increased platelet volume.
Collapse
|
47
|
Ritvo ER, Creel D, Realmuto G, Crandall AS, Freeman BJ, Bateman JB, Barr R, Pingree C, Coleman M, Purple R. Electroretinograms in autism: a pilot study of b-wave amplitudes. Am J Psychiatry 1988; 145:229-32. [PMID: 3341467 DOI: 10.1176/ajp.145.2.229] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The authors recorded electroretinograms for 27 autistic patients and 20 age- and sex-matched healthy volunteers. Thirteen (48%) of the autistic patients demonstrated subnormal b-wave amplitudes, which may indicate abnormal retinal function. One patient was tested serially at two sites; his low b-wave amplitude did not vary over time or between the two sites. If this retinal finding can be confirmed at other laboratories and in larger samples of autistic patients, it might provide a marker for a specific subtype of autism.
Collapse
|
48
|
|
49
|
Ritvo ER, Mason-Brothers A, Jenson WP, Freeman BJ, Mo A, Pingree C, Petersen PB, McMahon WM. A report of one family with four autistic siblings and four families with three autistic siblings. J Am Acad Child Adolesc Psychiatry 1987; 26:339-41. [PMID: 3597289 DOI: 10.1097/00004583-198705000-00010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
50
|
Asarnow RF, Tanguay PE, Bott L, Freeman BJ. Patterns of intellectual functioning in non-retarded autistic and schizophrenic children. J Child Psychol Psychiatry 1987; 28:273-80. [PMID: 3584297 DOI: 10.1111/j.1469-7610.1987.tb00210.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The WISC-R factor scores of non-retarded children meeting DSM III criteria for autism and schizophrenia were compared. The scores of the schizophrenic children on factor 3 were significantly lower than those of the autistic children, below the range of normal children, and significantly lower than the scores they obtained on the verbal comprehension and perceptual organization factors. The autistic children scored in the superior range on the block design subtest and did not show gross impairments in language function as indexed by scores on the verbal comprehension factor. The only subtest autistic children were impaired on was the comprehension subtest.
Collapse
|