Evidence-based assessment of cognitive functioning in pediatric psychology

Clinical characteristics of comorbid tic disorders in autism spectrum disorder: exploratory analysis

BACKGROUND

The frequency, clinical characteristics, and associated symptoms of comorbid tic disorders in individuals with autism spectrum disorder (ASD) remain unclear.

METHODS

We included subsets of individuals from a larger genetic study who were diagnosed with ASD (n = 679; age: 4-18 years) and completed the Yale Global Tic Severity Scale (YGTSS) questionnaire. Based on the YGTSS score, the individuals were divided into two groups: ASD only (n = 554) and ASD with tics (n = 125). Individuals were assessed using the verbal and non-verbal intelligence quotient (IQ), Vineland Adaptive Behavior Scale (VABS-2), Social Responsiveness Scale-2 (SRS-2), Child Behavior Checklists (CBCL), and Yale-Brown Obsessive-Compulsive Scale (YBOCS), followed by between-group comparisons. All statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 26.

RESULTS

Tic symptoms were observed in 125 (18.4%) participants; among them, most participants presented both motor and vocal tics (n = 40, 40.0%). The ASD with tics group had a significantly higher average age and full-scale IQ score than the ASD only group. After adjusting for age, the ASD with tics group had significantly higher scores in the SRS-2, CBCL, and YBOCS subdomains than the ASD only group. Furthermore, all variables except the non-verbal IQ and VABS-2 scores were positively correlated with the YGTSS total score. Finally, the proportion of tic symptoms was significantly higher among individuals with a higher IQ score (≥ 70).

CONCLUSIONS

The IQ score was positively correlated with the proportion of tic symptoms among individuals with ASD. Moreover, the severity of the core and comorbid symptoms of ASD was associated with the occurrence and severity of tic disorders. Our findings suggest the need for appropriate clinical interventions for individuals with ASD. Trial registration This study retrospectively registered participants.

Prenatal exposure to ambient air pollution is associated with neurodevelopmental outcomes at 2 years of age

BACKGROUND

Higher prenatal ambient air pollution exposure has been associated with impaired neurodevelopment in preschoolers and school-aged children. The purpose of this study was to explore the relationships between prenatal ambient air pollution exposure and neurodevelopment during infancy.

METHODS

This study examined 161 Latino mother-infant pairs from the Southern California Mother's Milk Study. Exposure assessments included prenatal nitrogen dioxide (NO2) and particulate matter smaller than 2.5 and 10 microns in diameter (PM2.5 and PM10, respectively). The pregnancy period was also examined as three windows, early, mid, and late, which describe the first, middle, and last three months of pregnancy. Infant neurodevelopmental outcomes at 2 years of age were measured using the Bayley-III Scales of Infant and Toddler Development. Multivariable linear models and distributed lag linear models (DLM) were used to examine relationships between prenatal exposures and neurodevelopmental scores, adjusting for socioeconomic status, breastfeeding frequency, time of delivery, pre-pregnancy body mass index, and infant birthweight and sex.

RESULTS

Higher prenatal exposure to PM10 and PM2.5 was negatively associated with composite cognitive score (β = -2.01 [-3.89, -0.13] and β = -1.97 [-3.83, -0.10], respectively). In addition, higher average prenatal exposure to PM10 was negatively associated with composite motor (β = -2.35 [-3.95, -0.74]), scaled motor (β = -0.77 [-1.30, -0.24]), gross motor (β = -0.37 [-0.70, -0.04]), fine motor (β = -0.40 [-0.71, -0.09]), composite language (β = -1.87 [-3.52, -0.22]), scaled language (β = -0.61 [-1.18, -0.05]) and expressive communication scaled scores (β = -0.36 [-0.66, -0.05]). DLMs showed that higher prenatal air pollution exposure during mid and late pregnancy was inversely associated with motor, cognitive, and communication language scores.

CONCLUSIONS

Higher exposure to air pollutants during pregnancy, particularly in the mid and late prenatal periods, was inversely associated with scaled and composite motor, cognitive, and language scores at 2 years. These results indicate that prenatal ambient air pollution may negatively impact neurodevelopment in early life.

Comparison of the Wechsler Preschool and Primary Scale of Intelligence-Third Edition and the Leiter-R Intellectual Assessments for Clinic-Referred Children

A review of clinical records was conducted for children with developmental, emotional, and behavioral difficulties who were assessed with both the Wechsler preschool and primary scale of intelligence-third edition (WPPSI-IIICDN; Wechsler, 2004) and the Leiter international performance scale-revised (Leiter-R; Roid & Miller, 1997) within the same psychological evaluation. Forty children, ages 3-7, were included in this study. Pearson correlations showed that the IQ scores of the two instruments are strongly related (r > .70; p < .001). However, paired t-tests showed that overall Leiter-R scores (M = 99.03) were significantly higher than WPPSI-IIICDN scores (PIQ; M = 82.28, FSIQ; M = 75.24) (p < .001). The discrepancies between the instrument's scores were clinically important as the use of only one of the two instruments could result in misclassification of child intellectual ability. These results should prompt professionals working with this clinical population to be cautious when using results from a single instrument in a child's intellectual evaluation.

Evaluation of the Wechsler Individual Achievement Test-Fourth Edition as a Measurement Instrument

The Wechsler Individual Achievement Test (WIAT-4) is the latest iteration of a popular instrument that psychologists employ to assess academic achievement. The WIAT-4 authors make both pragmatic and measurement claims about the instrument. The pragmatic claims involve being useful for identifying individuals in certain academic achievement-related groups (e.g., specific learning disability). The measurement claims are twofold: (a) the instrument’s scores represent psychological attributes, and (b) scores transformed to standard score values have equal-interval properties. The WIAT-4 authors did not provide the evidence necessary to support the pragmatic claims in the technical manual, so we could not evaluate them. Thus, we limited our evaluation to the measurement claims for the composite scores. To do so, we used information in the technical manual along with some additional factor analyses. Support for the first measurement claim varies substantially across scores. Although none of the evidence is particularly strong, scores in mathematics and reading domains tend to have more support than the writing and total achievement scores. Support for the second claim was insufficient for all scores. Consequently, we recommend that psychologists wishing to interpret WIAT-4 composite scores limit those interpretations to just a few in the mathematics and reading domains. Second, psychologists should completely refrain from using any composite score in a way that requires equal-interval values (e.g., quantitative score comparisons). Neither of these recommendations necessarily disqualifies the scores from being useful for pragmatic purposes, but support for these uses will need to come from evidence not currently provided in the WIAT-4 technical manual.

Prenatal Folate and Choline Levels and Brain and Cognitive Development in Children: A Critical Narrative Review

Women’s nutritional status during pregnancy can have long-term effects on children’s brains and cognitive development. Folate and choline are methyl-donor nutrients and are important for closure of the neural tube during fetal development. They have also been associated with brain and cognitive development in children. Animal studies have observed that prenatal folate and choline supplementation is associated with better cognitive outcomes in offspring and that these nutrients may have interactive effects on brain development. Although some human studies have reported associations between maternal folate and choline levels and child cognitive outcomes, results are not consistent, and no human studies have investigated the potential interactive effects of folate and choline. This lack of consistency could be due to differences in the methods used to assess folate and choline levels, the gestational trimester at which they were measured, and lack of consideration of potential confounding variables. This narrative review discusses and critically reviews current research examining the associations between maternal levels of folate and choline during pregnancy and brain and cognitive development in children. Directions for future research that will increase our understanding of the effects of these nutrients on children’s neurodevelopment are discussed.

Educational and economic returns to cognitive ability in low- and middle-income countries: A systematic review

There is growing interest to use early cognitive ability to predict schooling and employment outcomes in low- and middle-income countries (LMICs). Rather than using educational attainment and school enrollment as predictors of future economic growth or of improving an individual's earning potential, mounting evidence suggests that cognitive ability may be a better predictor. The relationship between cognitive ability, education, and employment are essential to predict future development in LMICs. We performed a systematic literature review and meta-analysis of the evidence regarding the relationship between cognitive ability and educational outcomes, and between cognitive ability and economic outcomes across LMICs. We searched peer-reviewed studies since 2000 that quantitatively measured these relationships. Based on an initial search of 3,766 records, we identified 14 studies, including 8 studies that examined the cognition-education link and 8 studies that assessed cognition-employment returns in LMICs. Identified studies showed that higher cognitive ability increased the probability of school enrollment, academic achievement, and educational attainment across LMICs. A meta-analysis of returns to wages from cognitive ability suggested that a standard deviation increase in cognitive test scores was associated with a 4.5% (95% CI 2.6%-9.6%) increase in wages. Investments into early cognitive development could play a critical role in improving educational and economic outcomes in LMICs. Further research should focus particularly in low-income countries with the least evidence, and examine the impact on education and economic outcomes by cognitive domains to provide more robust evidence for policy makers to take action.

Paternal Sensitivity and Children's Cognitive and Socioemotional Outcomes: A Meta-Analytic Review

In a series of meta-analyses, paternal sensitivity was associated with children's (age range: 7 months-9 years) overall cognitive functioning (N = 3,193; k = 23; r = .19), including language skills (k = 9; r = .21), cognitive ability (k = 9; r = .18), and executive function (k = 8; r = .19). Paternal sensitivity was not associated with children's overall socioemotional functioning (N = 2,924; k = 24; r = -.03) or internalizing problems, but it was associated with children's emotion regulation (k = 7; r = .22) and externalizing problems (k = 19; r = -.08). In the broad cognitive functioning, executive function, broad socioemotional functioning, and externalizing problems meta-analyses, child age was a significant moderator.

Cognitive Assessment of Children Who Are Deafblind: Perspectives and Suggestions for Assessments

The overall goal of a cognitive assessment is to improve communication, learning, and quality of life for a child who is deafblind. This article will give a brief description and perspective on different evaluation approaches as a basis for reliable cognitive assessments and offer suggestions on how to improve the quality of a cognitive assessment in our clinical practice. The assessor should be aware of the limitations of norm-referenced tests if standardized normative measures are applied to evaluate the cognitive functions of a child who is deafblind. However, if engaging a child with deafblindness in a standardized normative assessment, special considerations and assessment concessions would be required. Furthermore, key issues on how to improve the quality of a cognitive assessment by affording multiple assessment pathways for cognitive assessments will be addressed. Particular attention is given to the following assessment approaches: multi-method, multi-informant assessment, ecological assessment, and dynamic assessment. The use of multiple assessment pathways is necessary to reveal the genuine cognitive abilities and potentials of a child with deafblindness.

The cognitive footprint of medication: A review of cognitive assessments in clinical trials

WHAT IS KNOWN AND OBJECTIVE

Polypharmacy is common, and many medications have cognitive side effects. Such effects can be transient and subside when the drug in question is discontinued or can be long-lasting with effects present for years afterwards. Although formal assessment of cognition is feasible and often undertaken in neuropsychiatric trials, these effects are usually neglected in the evaluation of any non-neuropsychiatric health intervention. Medication effects can be assessed within a cognitive footprint framework, to account for the magnitude and the duration of cognitive side effects, with some likely to have a greater and more lasting effect than others.

COMMENT

Adverse event reporting suggests that many medications may be indirectly associated with cognitive effects, for example due to headaches, somnolence and 'dizziness'; however, inferring causation from adverse event reporting can be problematic. In order to better understand the impact of investigational drug and concomitant medications effect on cognition, it would be essential to ensure cognition is prioritized in drug development evaluation. It is suggested that simple instruments that can be easily incorporated into existing trial designs are used to assess the cognitive footprint of medication.

WHAT IS NEW AND CONCLUSION

We present an overview of existing measures of cognition that can be integrated into drug trials in order to provide a cognitive footprint. Like quality of life testing, such tests should be administered as a standard throughout the key assessment stages of the design of the trial to ensure that any effects on this equally important outcome are also documented. Furthermore, employing routine cognition testing may also enable researchers to identify unanticipated beneficial and non-beneficial effects on cognition. Provision of such a cognitive footprint profile of drugs may provide the necessary evidence to enable decision-makers to make informed decisions on risk-benefit analysis that can subsequently make trade-offs between different drug regimens.

The VIE study: feasibility of a physical activity intervention in a multidisciplinary program in children with cancer

BACKGROUND

Cancer is one of the leading causes of death in the world. The physiological and psychological benefits of physical activity have been shown in children with cancer. However, almost one in two cancer patients do not follow the physical activity guidelines. The aim of this study will be to assess the feasibility of a physical activity program intervention in pediatric oncology and to assess the barriers and facilitators to the success or failure of this physical activity program.

METHODS

The VIE (valorization, implication, and education) intervention is a multidisciplinary program including physical activity, nutritional, and psychological interventions in pediatric oncology. This study involves one intervention group that will be followed over 2 years (evaluations and physical activity interventions) and one control group that will participate in only one evaluation. Children from the intervention group have been diagnosed and will be undergoing treatment at the Charles-Bruneau oncology center from the Sainte-Justine University Health Center (Montreal, Canada). The feasibility of this program will be measured through a comparison between sessions performed and sessions scheduled, while the security will be measured according to the number of reported incidents.

DISCUSSION

This study will examine the effects of exercise in pediatric oncology from diagnosis to the expected end of treatment (i.e., 2 years of follow-up). Currently, there are only a few longitudinal studies on physical activity and pediatric cancer. Physiological and psychological tests will allow a better knowledge of the evolution of the physical fitness and mental health of the patients during the period of care. It is necessary to document and provide complementary knowledge in the pediatric oncology field in order to engage the discourse with pediatric oncology health professionals to help patients during and after treatment. This is an important study in the exercise and oncology field to help patients and their family during and after cancer treatments.

The Role of Cognitive and Psychosocial Maturity in Type 1 Diabetes Management

PURPOSE

The purpose of the article was to explore the longitudinal relationship between treatment responsibility and type 1 diabetes management (i.e., adherence and glycemic control) in adolescence and to examine whether indicators of cognitive and psychosocial maturity moderate the link between youth responsibility and diabetes outcomes.

METHODS

Participants included 117 youth with type 1 diabetes and their parents. Youth (aged 8-16 years) and parents were assessed five times over 2 years. Using a cohort sequential design, we estimated the growth trajectory of adherence and glycemic control (i.e., hemoglobin A1c [HbA1c]) from age 8 to 18 years. Treatment responsibility, verbal ability, and impulse control were used as predictors of within-person variability and between-person differences in the growth parameters (i.e., intercept and slope).

RESULTS

Adherence and HbA1c declined linearly from ages 8 to 18 years. Significant within-person interactions between impulse control and responsibility revealed that on occasions when youth experienced increases in both responsibility and impulse control, adherence and HbA1c were higher than would be predicted by the age-related trajectory. For adherence only, when youth acquired more responsibility, without experiencing contemporaneous gains in impulse control, adherence worsened. For glycemic control only, a significant within-person interaction indicated that time-specific increases in both youth responsibility and verbal capacity were associated with a concurrent decline in HbA1c.

CONCLUSIONS

The present findings underscore that the associations between treatment responsibility and diabetes management depend on youths' maturational context. Intervention efforts to enhance impulse control skills in youth with diabetes may prevent the decline in diabetes management that tends to occur as youth acquire more responsibility for diabetes-related tasks.

The Role of Cognition on Navigational Skills of Children and Adolescents With Autism Spectrum Disorders

PURPOSE

This study examined the role of cognition on the navigational process of a speech-generating device (SGD) among individuals with a diagnosis of autism spectrum disorder (ASD). The objective was to investigate the role of various cognitive factors (i.e., cognitive flexibility, sustained attention, categorization, fluid reasoning, and working memory) on the ability to navigate an SGD with dynamic paging and taxonomic grids in individuals with ASD.

METHOD

Twenty individuals aged 5 to 20 years with ASD were assessed using the Leiter International Performance Scale-Revised (Roid & Miller, 1997) and the Automated Working Memory Assessment (Alloway, 2007). They also completed a navigational task using an iPad 4 (Apple, 2017; taxonomic organization).

RESULTS

Significant correlations between all of the cognitive factors and the ability to navigate an SGD were revealed. A stepwise linear regression suggested that cognitive flexibility was the best predictor of navigational ability with this population.

CONCLUSION

The importance of cognition in the navigational process of an SGD with dynamic paging in children and adolescents with ASD has been highlighted by the results of this study.

Inflammatory biomarkers and intellectual disability in patients with Down syndrome

BACKGROUND

Intellectual disability (ID) is part of the Down syndrome (DS) phenotypic spectrum, but the exact molecular pathophysiology of ID in individuals with DS is not yet fully understood, with many research hypotheses still unproven. Basing on previous studies (which suggested a possible role of altered inflammatory response in DS-related ID), we assessed the serum levels of a number of inflammatory biomarkers [serum amyloid A (SAA), C-reactive protein (C-RP), high mobility group box-1 (HMGB1)] in a cohort of individuals with DS and healthy controls.

METHODS

In total, 24 children diagnosed with DS and 12 healthy controls were enrolled, and all underwent detailed cognitive assessment. Also, serum SAA, C-RP and HMGB1 levels were measured in all recruited subjects and correlated to the severity of ID in the DS group.

RESULTS

Serum SAA, C-RP and HMGB1 values were found to be significantly higher in the DS group compared with the healthy subjects (P = 0.001). In addition, serum HMGB1 levels positively correlated with C-RP and SAA in the DS group but not in the healthy controls. Only serum C-RP levels resulted inversely correlated (P < 0.01) with intelligence quotient (IQ); conversely, significant statistical correlations between serum SAA levels and IQ (as well as between HMGB1 and IQ) have been not found (P > 0.05).

CONCLUSIONS

The levels of the determined markers were higher in DS individuals compared with (cognitively) healthy subjects, and CRP showed a negative correlation with IQ in children with DS.

Attention Deficit Hyperactivity Disorder in Children With Sickle Cell Disease Referred for an Evaluation

Neuropsychological deficits, including difficulties with attention, are well described in children with sickle cell disease (SCD). Very little is known about attention deficit hyperactivity disorder (ADHD) in children with SCD. The objective of this study was to determine the proportion of ADHD in children with SCD referred for neuropsychological evaluation. This prospective, cross-sectional study included patients (age, 4 to 18 y) with SCD and completion of a neuropsychological evaluation between December 2013 and March 2016. Patients were referred for neuropsychological evaluation because of concern regarding school performance, development, and/or behavior. The diagnosis of ADHD was made by a neuropsychologist on the basis of the diagnostic criteria in the Diagnostic Statistical Manual-Fourth or Fifth Editions. ADHD medication usage rate was obtained by medical record review. Of the 89 patients with SCD referred for neuropsychological evaluation, 25% (95% confidence interval, 16%-35%) met diagnostic criteria for ADHD. Only 21% of the patients with SCD and ADHD were prescribed an ADHD medication. Our study supports routine ADHD screening in children with SCD who have poor school performance or behavioral concerns. Despite the benefits of pharmacologic treatment, the majority of patients with SCD and ADHD did not receive a medication for management of their ADHD.

Patterns and Correlates of Serostatus Disclosure to Sexual Partners by Perinatally-Infected Adolescents and Young Adults

Similar to same-age peers, perinatally HIV-infected (PHIV+) youth in the US are engaging in sex, including condomless sex. Understanding decisions about serostatus disclosure to sexual partners is important to domestic and global HIV prevention efforts, since large numbers of PHIV+ children are entering adolescence and becoming sexually active. Using Social Action Theory (SAT) to inform variable selection, we examined correlates of disclosure among 98 PHIV+ adolescents/young adults in New York City. Over half of these youth reported not disclosing to any casual partners (59 %) or to any partners when using condoms (55 %). In bivariate analyses, increased disclosure was associated with older age; being female; earlier age of learning one's serostatus; and increased STD knowledge, disclosure intentions, and parent-child communication. Multiple regression analyses revealed a strong fit with the SAT model. As with adults, disclosure to sexual partners is difficult for PHIV+ youth and challenges prevention efforts. Effective interventions that help youth with disclosure decisions are needed to curb the epidemic.

Early childhood exposure to short periods of sevoflurane is not associated with later, lasting cognitive deficits

BACKGROUND

A detrimental effect of commonly used anesthetics on the neurodevelopmental and behavioral parameters has long been shown in young animals subjected to early childhood anesthesia. Epidemiologic studies suggest the possibility of a modestly elevated risk of adverse neurodevelopmental outcomes in children exposed to anesthesia during early childhood. However, these results are still preliminary and inconclusive.

AIM

To further elucidate the probability of occurrence of such adverse outcomes, we evaluated cognitive performance of children who underwent general anesthesia early in their childhood.

METHOD

One hundred and fifteen children aged 5-16 years with established glaucoma were included in the study. Of these, 68 children had a history of at least one general anesthesia with sevoflurane before age 3. Phonemic and semantic verbal fluency, and forward and backward digit span tests were performed to evaluate cognitive function in the study subjects.

RESULTS

The two-way anova revealed that all these variables showed significant changes in various age groups, but they were comparable among subjects with no, single, or multiple childhood anesthesia.

CONCLUSION

It can be concluded that brief periods of anesthesia with single anesthetic sevoflurane may be safe for children under age 3.

Contributions of a Child's Built, Natural, and Social Environments to Their General Cognitive Ability: A Systematic Scoping Review

The etiology of a child’s cognitive ability is complex, with research suggesting that it is not attributed to a single determinant or even a defined period of exposure. Rather, cognitive development is the product of cumulative interactions with the environment, both negative and positive, over the life course. The aim of this systematic scoping review was to collate evidence associated with children’s cognitive health, including inherent factors as well as chemical and non-chemical stressors from the built, natural, and social environments. Three databases were used to identify recent epidemiological studies (2003–2013) that examined exposure factors associated with general cognitive ability in children. Over 100 factors were evaluated from 258 eligible studies. We found that recent literature mainly assessed the hypothesized negative effects of either inherent factors or chemical exposures present in the physical environment. Prenatal growth, sleep health, lead and water pollutants showed consistent negative effects. Of the few studies that examined social stressors, results consistently showed cognitive development to be influenced by both positive and negative social interactions at home, in school or the community. Among behavioral factors related to diet and lifestyle choices of the mother, breastfeeding was the most studied, showing consistent positive associations with cognitive ability. There were mostly inconsistent results for both chemical and non-chemical stressors. The majority of studies utilized traditional exposure assessments, evaluating chemical and non-chemical stressors separately. Collective evidence from a limited number of studies revealed that cumulative exposure assessment that incorporates multiple chemical and non-chemical stressors over the life course may unravel the variability in effect on cognitive development and help explain the inconsistencies across studies. Future research examining the interactions of multiple stressors within a child’s total environment, depicting a more real-world exposure, will aid in understanding the cumulative effects associated with a child’s ability to learn.

Decline of General Intelligence in Children Exposed to Manganese from Mining Contamination in Puyango River Basin, Southern Ecuador

Based on ecosystem approaches to health (Ecohealth), this study sought to identify neurobehavioral disorders in children exposed to several levels of toxic metal pollution from gold mining in the Puyango River Basin, Southern Ecuador. Ninety-three children born or living in the study area participated in the study. A neurobehavioral test battery consisting of 12 tests assessing various functions of the nervous system was applied as well as a questionnaire regarding events of exposure of children's mothers to contaminants during perinatal period. Hair samples were taken from children to determine manganese concentrations. Descriptive and inferential statistics were applied in order to examine possible relationships between exposure events, hair manganese, and neurobehavioral disorders. Having controlled co-variables such as age and educational level, it was found that children with elevated levels of hair manganese (over 2 μg/g) had poor performance in the test of general intelligence (Raven's Progressive Color Matrices Scale PCM). The Ecohealth approach helped to identify that children in the lower Puyango Basin with very elevated levels of manganese in the river water (970 µg/L) are the ones who have the highest levels of hair manganese and the worst performance in the intelligence test.

A neuropsychological profile of childhood maltreatment within an adolescent inpatient sample

Recent research has begun to identify the neurocognitive and psychological effects of childhood maltreatment, although information is limited on the neuropsychological presentation of maltreatment in psychiatrically hospitalized adolescents. This study examined the executive-functioning and language abilities as well as psychopathological presentation of childhood maltreatment victims in an adolescent psychiatric inpatient setting. The sample consisted of adolescent inpatients (ages 13-19 years old) who completed a neuropsychological/psychological assessment during hospitalization (n = 122). The sample was grouped based on childhood maltreatment history, with one group categorized by maltreatment history (n = 49) and the other group characterized by no maltreatment history (n = 73). Analyses revealed statistically significant differences (p < .01) between maltreatment groups on executive functioning, as well as on measures of self-reported depression and anxiety symptoms. No group differences remained after controlling for posttraumatic stress disorder. Further, distinct neuropsychological profiles were identified for specific types of maltreatment experienced. These findings suggest that while childhood maltreatment is associated with a range of neuropsychological impairments, the specific type of maltreatment experienced may have a significant influence on the type and severity of impairments. These findings contribute to the growing body of research on the significant consequences of childhood maltreatment.

Comparison of the Leiter International Performance Scale-Revised and the Stanford-Binet Intelligence Scales, 5th Edition, in children with autism spectrum disorders

A review of hospital records was conducted for children evaluated for autism spectrum disorders who completed both the Leiter International Performance Scale-Revised (Leiter-R) and Stanford-Binet Intelligence Scales, 5th Edition (SB5). Participants were between 3 and 12 years of age. Diagnoses were autistic disorder (n  =  26, 55%) and pervasive developmental disorder-not otherwise specified (n  =  21, 45%). Analysis showed that the full sample received significantly higher scores on the Leiter-R than SB5 (mean discrepancy of 20.91 points), specific diagnosis was not a significant factor, and younger children had a larger discrepancy between tests. These analyses strongly suggest that the Leiter-R and the SB5 may not be equivalent measures of intellectual functioning in children with autism spectrum disorders, and that use of one or the other exclusively could lead to misclassification of intellectual capacity.