Symptoms in the first two years of life. A preliminary population study of infantile autism

A population sample of autistic children (n = 26) were compared retrospectively with age- and sex-matched mentally retarded children (n = 20) and age- and sex-matched population-representative children (n = 25) on a 130-item questionnaire to the mother concerning characteristic features of the child's behaviour in the first 2 years of life. Thirteen items discriminated clearly between the groups. The results are discussed in the context of early screening for autism.

Children with preschool minor neurodevelopmental disorders. IV: Behaviour and school achievement at age 13

A cohort of children with deficits in attention, motor control and perception at seven years, drawn from a total population sample of such children in Göteborg, Sweden, was compared at 13 years with a group of normal children with regard to behaviour and school achievement. The index group showed persisting high rates of severe behavioural problems, as judged by teachers', parents' and self-rating questionnaires. None had been treated with stimulants or other drugs to reduce the symptoms of their neurodevelopmental disorders. It seems that these children's problems were slightly less in the early teen years than they were at 10 years, but the rates were still much in excess of those in the comparison group.

Children with preschool minor neurodevelopmental disorders. V: Neurodevelopmental profiles at age 13

A cohort of children diagnosed at age seven as suffering from deficits in attention, motor control and perception was compared at age 13 with a group of children without such problems. More than two-thirds of the index children no longer had any clearly detectable motor problems at 13, but they still had significantly prolonged complex reaction times. These results suggest that children with these deficits in the early school years have a fair biological prognosis by the early teen years.

Chromosome findings in twins with early-onset autistic disorder

In a twin study of autistic disorder, chromosome analyses were carried out in nine pairs of monozygotic (MZ) twins, two pairs of dizygotic (DZ) twins, one set of MZ triplets, one single twin from a MZ pair, and seven single twins from DZ pairs. All but one of the MZ sets were concordant for autistic disorder; all DZ pairs were discordant. Fragile X(q)(27.3) was found in one pair of MZ twins and in MZ triplets, i.e., in 9% of the population with autistic disorder. A marker chromosome of unknown origin was detected in a male twin with autistic disorder from a discordant DZ pair.

Infantile autism, fragile (X) (q27.3) and RFLP analysis in an extended Swedish family

In an extended family with eight individuals with infantile autism, in association with other developmental disorders and fragile (X) (q27.3), DNA techniques were used to investigate linkage between X chromosomal probes and the disorder. F9 was not informative and recombination was found between fragile X and DXS15, DXS51 and DXS52.

Monozygotic female twins with autism and the fragile-X syndrome (AFRAX)

Identical female twins with the combination of infantile autism, mild-moderate mental retardation and the fragile-X (q27.3) chromosome abnormality are described. The case report highlights the need for chromosomal cultures in both boys and girls presenting with the "Kanner syndrome".

Epilepsy in autism and autisticlike conditions. A population-based study

In a population-based study from Göteborg, Sweden, of infantile autism in children under age 10 years, we found epilepsy in 20% of the cases. Twice as many children among those with "autisticlike conditions" had epilepsy. All types of epilepsy were seen. Of the children in the study who had epilepsy, almost 75% (10/14) had psychomotor epilepsy. The association between autism-autisticlike conditions and epilepsy seemed to be with the behavioral disorder and not with the often concomitant mental retardation. Abnormalities evidenced on electroencephalograms seemed to be generated from the temporal regions and phylogenetically older parts of the brain in a majority of the cases.

Infantile autism and urinary excretion of peptides and protein-associated peptide complexes

Sixty-nine early morning urine samples obtained from three groups of young adult males (autistic, mentally handicapped, and a group of men of normal intelligence) were analyzed using the methods described by Trygstad et al. (1980). No consistent patterns of urinary chromatographic profiles were identified. A number of possible contributing factors are discussed in relation to this failure to replicate the results of previous studies.

School refusal: a 15-20-year follow-up study of 35 Swedish urban children

Results from a 15-20-year follow-up study of 35 7-12-year-old children with school refusal and 35 age- and sex-matched comparison children are reported. The school refusal cases had applied for out-patient adult psychiatric care more often than comparison children. Also they had fewer children of their own. In respect of overall social adjustment and severe psychiatric disorders requiring in-patient treatment, there were no important differences.

Oculomotor findings in autistic children

Eleven children with infantile autism or autistic-like conditions were examined with oculomotor tests and with auditory brainstem response audiometry. Measurements of voluntary, horizontal non-predictable saccades showed that the eye motor function was abnormal in six (55 per cent) of the eleven patients. The saccades were hypometric in all six instances and the saccadic velocity was reduced in four instances. The abnormalities observed are consistent with brain dysfunction, in most cases probably indicating pontocerebellar involvement. In five instances ABR was found to be abnormal which indicates brainstem dysfunction. Oculomotor dysfunction and/or ABR abnormality was observed in eight (73 per cent) of the patients studied.

Neurobiological findings in 20 relatively gifted children with Kanner-type autism or Asperger syndrome

Seventeen children with classical Kanner autism and three children with Asperger syndrome, all of whom had Full-scale IQs above 65, were subjected to a neurobiological assessment, including CAT scan, auditory brainstem response, EEG, chromosomal cultures, cerebrospinal fluid, blood and urine examinations and a thorough physical examination. 15 of the 20 children had 'definite abnormalities' on at least one of these examinations. It is concluded that the number of cases of 'non-organic' autism, even among children with relatively higher intelligence, dwindles rapidly as our neurobiological assessment methods become increasingly sophisticated.

CSF monoamines in autistic syndromes and other pervasive developmental disorders of early childhood

Spinal fluid concentrations of the three major monoamine metabolites were examined in 25 infantile autistic children and 12 children with other childhood psychoses, and were contrasted with results obtained in normal children and in groups of children with neurological and neurodevelopmental disorders. Autistic children showed absolute and relative increases of the dopamine metabolite homovanillic acid. The group with other childhood psychoses also showed an increase in HVA level; in this group there were also indications of high levels of serotonin and norepinephrine metabolites. The results are discussed in the context of a pathogenetic model for autism involving hyperfunction of dopaminergic nerve fibres in the brain stem-mesolimbic system.

Infantile autism in children of immigrant parents. A population-based study from Göteborg, Sweden

A population-based study of infantile autism from western Sweden has been completed. Urban children with autism more often than age-matched children in the general population had immigrant parents from 'exotic' countries. No such trend was seen in rural children with infantile autism.

Outcome and prognostic factors in infantile autism and similar conditions: a population-based study of 46 cases followed through puberty

This follow-up study reports data from a population-based series of children in the Göteborg region of Sweden diagnosed in childhood as suffering from infantile autism and other childhood psychoses and followed through to the ages of 16-23 years. The results of the study are in good accord with the only previous population-based study of the same kind. IQ at diagnosis and communicative speech development before 6 years were the most important prognostic factors, but other trends were seen that also compare favorably with previous studies. Some previously unreported trends also emerged.

Autistic symptoms in Rett syndrome: the first two years according to mother reports

Eight mothers of eight young Rett syndrome girls were interviewed in respect of early symptoms in the child. A questionnaire originally developed to tap early symptoms in infantile autism was used. Considerable overlap between early symptoms in Rett syndrome and infantile autism was seen, although clear differentiating features might be present already in the first few years of life.

Folic acid as an adjunct in the treatment of children with the autism fragile-X syndrome (AFRAX)

Four boys with the combination of infantile autism and the fragile-X syndrome were given oral folic acid and placebo, according to a double-blind crossover design. One boy's behaviour appeared to improve on folic acid, but another boy did not seem to be affected at all. For the remaining two boys the results were equivocal. Further study of folic acid in the treatment of autistic boys with the fragile-X syndrome is warranted.

Autism and autistic-like conditions in Swedish rural and urban areas: a population study

The total population of children under 10 years in one Swedish urban area and one rural area was screened for infantile autism (IA) and autistic-like conditions (AC). A total prevalence of 6.6 per 10 000 was found, which is somewhat higher than in previous similar studies of the same region. Infantile autism accounted for two-thirds of the cases. Boys far outnumbered girls, but this was entirely accounted for by the IA group. The preponderance of autistic boys was less pronounced among the severely mentally retarded children. Mental retardation was seen in almost 90% of cases and only one child had an IQ exceeding 100; clinical and laboratory signs of brain dysfunction were also found in a majority of cases. Distribution by social class was no different in either patient group from the general population.