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Research about autism spectrum disorder (ASD) supports variation in symptom presentations across settings, and there is a growing literature that explicates how this variability may improve characterization of the autism phenotype. Capitalizing on a well-established literature on informant discrepancy as an index of contextual variability, research suggests that differing parent and teacher perceptions may impact treatment or education-related outcomes. A prior investigation by Lerner and colleagues suggests that parent-teacher discrepancies in ASD symptom ratings define discrete and clinically meaningful subgroups. However, replication in a larger sample is important to support the validity and utility of the subgroups for use in research and practice.The present paper used latent profile analysis (LPA) to (1) replicate the previous study by Lerner and colleagues in a larger sample of 514 clinic-referred autistic youth (aged 6-18, 83.2% male, 90.4% White, IQ 19-140) and (2) determine if parent-teacher informant discrepancies relate to clinical and functional correlates. We hypothesized that parent-teacher discrepancies in ASD symptom severity ratings would validly characterize ASD subgroups and predict clinical and functional correlates.The results of the LPA supported a 4-profile solution made up of two parent-teacher agreement groups (high parent-teacher, 21.2%, and low parent-teacher, 34.2%) and two parent-teacher discrepancy groups (high parent-low teacher, 18.1%, and moderate parent-high teacher, 26.5%), replicating findings from Lerner and colleagues. Latent profile membership differentially predicted IQ, age, and educational outcomes of participants.Unique, clinically useful information about the taxonomy and impact of ASD is obtained by considering informant discrepancies in symptom severity ratings, which underscores the importance of considering contextual variability assessed through multiple informants.

This article sets out to investigate alcohol and substance use (ASU) among adolescents living with HIV (ALWH) in the sub-Saharan African setting of Uganda. A cross-sectional analysis of the records of 479 adolescents (aged between 12and 17 years) attending the study, "Mental health among HIV infected CHildren and Adolescents in KAmpala and Masaka, Uganda (the CHAKA study)" was undertaken. ASU was assessed through both youth self-report and caregiver report using the Diagnostic and Statistical Manual of Mental Disorders-5 referenced instruments, the Youth Inventory-4R and the Child and Adolescent Symptom Inventory-5 (CASI-5). Rates and association with potential risk and outcome factors were investigated using logistic regression models. The rate of ASU was 29/484 (5.9%) with the most frequently reported ASU being alcohol 22/484 (4.3%) and marijuana 10/484 (2.1%). Functional impairment secondary to ASU was reported by 10/484 (2.1%) of the youth. ASU was significantly associated with urban residence, caregiver psychological distress and the psychiatric diagnosis of post-traumatic stress disorder. On associations with negative outcomes, ASU was significantly associated with only "ever had sex". Health care for ALWH in sub-Saharan Africa should include ASU prevention and management strategies.

We describe the process of locally adapting and validating the international psychiatric symptom screening instrument, the Child and Adolescent Symptom Inventory-Progress Monitor-parent version (CA...

This study compared atypical communication characteristics (ACCs) in clinic-referred youth with and without autism spectrum disorder (ASD), identified subgroups based on different patterns of ACCs in youth with ASD, and determined if ACC subgroups result in meaningful clinical phenotypes in their relation to psychopathology and functional outcomes. Youth 6-18 years of age (

Diagnostic accuracy of the Diagnostic and Statistical Manual of Mental Disorders–oriented Child and Adolescent Symptom Inventory (CASI-4R) Psychotic Symptoms scale was tested using receiver operati...

Oppositional defiant disorder (ODD) is a common comorbidity of attention-deficit/hyperactivity disorder (ADHD) in both children and adolescents. Although there is research demonstrating that ADHD persists into adulthood, less is known about the frequency of its persistence, clinical characteristics, and impairment when associated with comorbid ODD in adults with ADHD.Data from a randomized clinical trial of adults with ADHD were analyzed to determine the prevalence and clinical correlates of comorbid ODD. As per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria, patients who reported having ≥ 4 symptoms "often" or "very often" were classified as meeting the symptom criteria for the disorder.Forty percent of this sample met symptom criteria for ODD. Subjects with ODD were more likely to have other comorbid disorders, lower investigator ratings of overall functioning, and lower patient life satisfaction (P0.05). A regression analysis using these variables predicted 40% of the variance of ODD as a comorbid condition in addition to ADHD. Although the presence or absence of ODD at baseline does not moderate response of ADHD symptoms with treatment, improvement in ODD symptoms was mediated by improvement in ADHD symptoms (P0.0001). Oppositional defiant disorder treatment was more responsive to dextroamphetamine than paroxetine, despite the contribution of irritability and reactive tantrums, as symptoms of the disorder.Oppositional defiant disorder is a valid and impairing disorder requiring evaluation and treatment in adults.

Rating scales developed to measure child emotional and behavioral problems typically are so long as to make their use in progress monitoring impractical in typical school settings. This study examined two methods of selecting items from existing rating scales to create shorter instruments for use in assessing response to intervention. The psychometric properties of two sets of abbreviated rating scales derived from the IOWA Conners Teacher Rating Scale and the teacher-completed Peer Conflict Scale were examined and compared to the longer original versions of these scales. The rating scales were evaluated using data from a randomized, placebo-controlled, crossover trial of immediate release methylphenidate involving a sample 65 children between 6 and 12 years old who met research diagnostic criteria for attention deficit hyperactivity disorder and either chronic motor tic disorder or Tourette's disorder. Specifically, the abbre- viated and original versions of the rating scales were examined for internal consistency, temporal stability, concurrent validity, and treatment sensitivity. Results indicate that there were few significant differences between versions of the scales, which support the use of abbreviated rating scales for use in progress monitoring. Implications for practice and future research are discussed.

Potential risk factors for conduct problems and depressive symptoms were tested in a cohort of 10- to 12-year-old Ukrainian children (N = 544, 47.6% male). Risk factors examined were child emotional lability, child attention problems, poor mother-child communication, coercive maternal discipline, maternal depression, and low marital satisfaction. Results indicated that poor mother-child communication was related to conduct problems and depressive symptoms for both boys and girls. In addition, conduct problems and depression were associated with attention problems for boys and with low marital satisfaction for girls. Emotional lability was related specifically to conduct problems, and maternal punishment was related specifically to depressive symptoms.

Examined reliability and validity of the parent version of the Child Symptom Inventory (CSI-4) in 247 boys between 6.0 and 10 years 11 months old referred for evaluation of behavioral and emotional problems. The CSI-4 is a behavior rating scale whose items correspond to the symptoms of disorders defined by the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994). Results indicated satisfactory internal consistency reliability, test-retest reliability, and temporal stability over a 4-year period for most symptom categories. CSI-4 ratings converged and diverged in a theoretically consistent pattern with respective scales of the Child Behavior Checklist (CBCL; Achenbach, 1991a) and the Diagnostic Interview for Children and Adolescents-Revised-Parent Version (DICA-P; Reich, Shayka, & Taibleson, 1991). Discriminant validity was established in that boys with specific DICA-P diagnoses received significantly higher corresponding CSI-4 parent symptom ratings than boys not so diagnosed. Clinical utility (sensitivity, specificity, positive predictive power, negative predictive power) was evaluated for screening cutoffs based on categorical (DSM-IV) and dimensional (normative distribution of Symptom Severity scores) scoring methods.

Examined the relation between ratings and observations of 34 hyperactive children in public school settings within the context of placebo-controlled, double-blind stimulant drug evaluations. The findings indicated that rating scale scores were significantly correlated with classroom, lunchroom, and playground observations of negativistic (e.g., aggression, noncompliance, interference) but not hyperactive (in-attention, motor movement) behaviors. However, when these same data were analyzed controlling for the variance accounted for by the other dimension (partial correlations), there was clear evidence supporting the differential validity of hyperactivity and negativistic behavior scales of the IOWA Conners Teacher's Rating Scale (Loney & Milich, 1982) and the Abbreviated Teacher Rating Scales (Conners, 1973) across settings and as measures of drug response. Test-retest reliabilities of most rating scales and classroom-observation code categories were comparable.

Describes a school-based medication evaluation (SBME) procedure that employs direct observations of child behavior. Numerous survey studies of hyperactive children receiving stimulant medication during the past 20 years have found procedures for evaluating drug response to be wanting. One of the major problems in this area is the lack of precision in dosage selection. A case study is presented to illustrate the strengths of the SBME. Limitations of the SBME are addressed as are alternative models for assessing drug effects.

A controlled case study of a severely hyperactive, moderately retarded 4-year-old boy was conducted in which the efficacy of methylphenidate, fenfluramine, and placebo was assessed. Four separate placebo-controlled evaluations were conducted over a 2.5 year period. Initially, methylphenidate was clinically effective in decreasing overactivity; however, it was later shown to exacerbate the child's symptoms. In a subsequent drug evaluation, flenfluramine was found to produce dramatic behavioral improvement. Procedures for and difficulties with assessing drug response in this patient population are discussed.

Forty-eight boys and 43 girls (age: range = 5.0 to 9.5 years) from a public elementary school participated in this evaluation of a critical television viewing skills curriculum. One class of kindergarteners and one class of second graders were taught the curriculum (14 half-hour lessons) by their regular teachers. Another class at each grade level served as no-treatment controls. Comparison of pretest and posttest scores on a comprehension test of reality versus fantasy portrayals, special effects, and commercials revealed significant knowledge gains by the children who received the curriculum. Pretest and posttest scores on an opinion questionnaire showed no parallel shift in the children’s attitudes about television after training. The educational and social implications of the findings are discussed.

We administered the Stony Brook Videotest (SBV), a measure of reality perceptions of television programs and commercials, to 104 school-labeled learning-disabled (LD) children in self-contained classes and to 229 nonhandicapped elementary school children. The LD children scored significantly lower than the comparison group, even when IQ was controlled, indicating that LD children are less able to distinguish between reality and fantasy on television. The clinical implications of these findings and possible remedial actions are discussed.