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Background: Behavioral symptom trajectories are informative of the development of young children at increased likelihood for autism spectrum disorder (ASD). Methods: Developmental trajectories of early signs were examined in a cohort of siblings of children diagnosed with ASD (n = 502) from 6 to 18 months using the Autism Observation Scale for Infants (AOSI), and from 18 months to 5–7 years using the Autism Diagnostic Observation Schedule (ADOS). Diagnostic outcomes for ASD at age 3 confirmed diagnosis for 137 children. We further analyzed the conditional probability of a switch from a trajectory measured with the AOSI to a trajectory measured with the ADOS as well as predictors from age 6 months. Results: We derived three early trajectories of behavioral signs ("Low," "Intermediate," and "Increasing") from 6 to 18 months using the AOSI. We then derived three similar, distinct trajectories for the evolution of symptom severity between 18 and 60–84 months of age (Low, Intermediate, Increasing) using the ADOS. Globally, the Low trajectory included children showing fewer ASD signs or symptoms and the Increasing trajectory included children showing more severe symptoms. We also found that most children in the Low AOSI trajectory stayed in the corresponding ADOS trajectory, whereas children in an Increasing AOSI trajectory tended to transition to an Intermediate or Increasing ADOS trajectory. Developmental measures taken at 6 months (early signs of ASD, Fine Motor, and Visual Reception skills) were predictive of trajectory membership. Conclusions: Results confirm substantial heterogeneity in the early emergence of ASD signs in children at increased likelihood for ASD. Moreover, we showed that the way those early behavioral signs emerge in infants is predictive of later symptomatology. Results yield clear clinical implications, supporting the need to repeatedly assess infants at increased likelihood for ASD as this can be highly indicative of their later development and behavior. [ABSTRACT FROM AUTHOR]

Research concerning temperament in children and adults with autism spectrum disorder (ASD) has suggested a consistent profile of low positive affect, high negative affect, and low regulation (Visser et al., 2016). One area receiving less attention is individual differences among children diagnosed with ASD. The primary objective of this study was to use a person‐centered approach to explore heterogeneity of early temperament precursors of regulation in a large sample of infants with elevated familial likelihood of ASD. Early precursors of regulation included temperament assessed at 6, 12, and 24 months whereas outcome measures were diagnosis of ASD, cognitive ability and adaptive behavior at 36 months. Participants included 176 low‐likelihood and 473 elevated‐likelihood infants, 129 of whom were diagnosed with ASD at 3 years. Results supported a three‐profile solution: a well‐regulated profile (high positive affect and high attentional focus and shifting), a low attention focus profile (higher attentional shifting compared to attentional focus), and a low attention shifting profile (higher attentional focus compared to attentional shifting). A higher proportion of children diagnosed with ASD were classified into the low attention shifting profile. Furthermore, children with the well‐regulated profile were differentiated from the other profiles by a pattern of higher social competence and lower dysregulation whereas children with the low attention focus profile were distinguished from the other profiles by higher cognitive ability at 3 years. The findings indicate that the combination of early positive affect with attention measures may provide an enhanced tool for prediction of self‐regulation and later outcomes. [ABSTRACT FROM AUTHOR]

Delays in motor development are not considered a core feature of autism spectrum disorder (ASD). Yet, recent studies of infant siblings of children with ASD suggest that early delays in motor skills may be associated with later delays in developmental areas considered to be core features of an ASD diagnosis. While these studies demonstrate the longitudinal association between core features and motor delays observed at single time points, there is considerable interest in studying the trajectories of motor development over the first 3 years of life. To accomplish this, we investigated early trajectories of motor development in a cohort of 499 infant siblings of children with ASD and 176 children with no family history of ASD. Data for the current study were drawn from the prospective, multi‐site, Canadian Infant Sibling Study. We evaluated trajectories of fine and gross motor development over the first 3 years using group‐based trajectory modeling. Our results show that membership for both fine and gross motor trajectory groups was related to expressive language skills, receptive language skills, ASD symptom severity scores, and diagnostic classification at age 3. These results provide evidence that the trajectory of a child's early motor development may have important prognostic implications in ASD. Lay Summary: Difficulties with motor skills are not included in current diagnostic criteria for autism spectrum disorder (ASD) but have gained attention in recent studies of ASD in early life. By tracking development of infants over the first 3 years of life, our work shows that motor impairments may set the stage for later impairments in ASD. In infants with an elevated likelihood of developing ASD, the patterns of early motor development may predict the probability of receiving an ASD diagnosis, later language skills, and severity of symptoms. [ABSTRACT FROM AUTHOR]

Background: Although early autism spectrum disorder (ASD) detection strategies tend to focus on differences at a point in time, behavioral symptom trajectories may also be informative. Methods: Developmental trajectories of early signs of ASD were examined in younger siblings of children diagnosed with ASD (n = 499) and infants with no family history of ASD (n = 177). Participants were assessed using the Autism Observation Scale for Infants (AOSI) from 6 to 18 months. Diagnostic outcomes were determined at age 3 years blind to previous assessments. Results: Semiparametric group‐based modeling using AOSI scores identified three distinct trajectories: Group 1 ('Low', n = 435, 64.3%) was characterized by a low level and stable evolution of ASD signs, group 2 ('Intermediate', n = 180, 26.6%) had intermediate and stable levels, and group 3 ('Inclining', n = 61, 9.3%) had higher and progressively elevated levels of ASD signs. Among younger siblings, ASD rates at age 3 varied by trajectory of early signs and were highest in the Inclining group, membership in which was highly specific (94.5%) but poorly sensitive (28.5%) to ASD. Children with ASD assigned to the inclining trajectory had more severe symptoms at age 3, but developmental and adaptive functioning did not differ by trajectory membership. Conclusions: These prospective data emphasize variable early‐onset patterns and the importance of a multipronged approach to early surveillance and screening for ASD. [ABSTRACT FROM AUTHOR]

The objectives were to characterize behavioral signs of autism spectrum disorder (ASD) in younger siblings of diagnosed children (high‐risk; HR) and examine classification features of the Autism Observation Scale for Infants (AOSI). Participants (501 HR and 180 low‐risk [LR]) were assessed between 6 and 18 months using the AOSI and at age 3 for ASD diagnoses. Total AOSI scores differentiated HR infants later diagnosed with ASD starting at 12 months. ROC analyses identified 12‐ and 18‐month cutoff scores associated with 0.52 sensitivity and 0.74 specificity and 0.73 sensitivity and 0.65 specificity, respectively. Although classification accuracy does not support use as a standalone screen, the AOSI identifies features associated with ASD starting at 6 months and differentiates HR infants with ASD by 12 months. [ABSTRACT FROM AUTHOR]

Background: Children with autism spectrum disorder (ASD) often experience impairments in adaptive behavior. Methods: Developmental trajectories of adaptive behavior in ASD were examined in children from high‐risk (siblings of children diagnosed with ASD, n = 403) and low‐risk (no family history of ASD, n = 163) families. Children were assessed prospectively at 12, 18, 24, and 36 months of age using the Vineland Adaptive Behavior Scales and underwent a blind independent diagnostic assessment for ASD at 36 months of age. Results: The semi‐parametric group‐based modeling approach using standard scores on the Adaptive Behavior Composite revealed three distinct developmental trajectories: (a) Group 1 (21.2% of sample) showed average performance at 12 months and a declining trajectory; (b) Group 2 (52.8% of the sample) showed average performance at 12 months with a slightly declining trajectory; and (c) Group 3 (26.0% of the sample) showed a higher level of adaptive behavior at 12 months and a stable trajectory. The Mullen Scales of Early Learning Early Learning Composite and the Autism Observation Scale for Infants total score at 6 and 12 months predicted trajectory membership. Conclusions: The results emphasize heterogeneous development associated with ASD and the need for interventions tailored to individual presentations. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is associated with early differences in children's social interactions, communication, and play/interests. In many countries, considerable resources are invested in early intensive behavioral intervention (EIBI) programs for children with ASD, which aim to build adaptive skills and prevent or treat problem behavior. However, these programs vary widely in structure and delivery. Research evidence supports the efficacy of EIBI, but large knowledge gaps remain about the effectiveness of publicly funded EIBI programs. With policy‐makers as formal research partners, we compared children's progress over 1 year in public preschool programs in adjacent Canadian provinces, New Brunswick (NB) and Nova Scotia (NS). In NB, children received up to 20 hr/week of comprehensive EIBI in a publicly funded, privately provided program. In NS, children received up to 15 hr/week of Pivotal Response Treatment and Positive Behavior Support delivered through the publicly funded healthcare system. In this observational parallel cohort study, we collected parent‐reported data on 298 NB preschoolers (76.5% boys) and 221 NS preschoolers (86.9% boys) at EIBI start and 1 year later. Multilevel analysis revealed significant differences at baseline: NS children were older, with lower adaptive functioning and more severe ASD symptoms than NB children. Despite these pre‐treatment differences that favor NB, children in both provinces showed similar adaptive functioning gains and reductions of maladaptive behavior. No changes were seen in mean ASD symptom severity in either province over time. Results highlight the value of evaluating interventions in their implementation contexts, and have important implications for devising optimal ASD policy. Autism Research 2019, 12: 667–681. © 2019 International Society for Autism Research,Wiley Periodicals, Inc. Lay Summary: We need to know more about the impact of different forms of early intensive behavioral intervention (EIBI) for young children with autism spectrum disorder (ASD). We showed that preschoolers with ASD gained important skills while in public EIBI programs in two Canadian provinces. We also saw that differences in how EIBI programs are structured and characteristics of children who are served may affect outcomes. For these reasons, policy making requires evidence that fits the local context. [ABSTRACT FROM AUTHOR]

Parent and clinician agreement regarding early behavioral signs of Autism Spectrum Disorder (ASD) in children from a high‐risk cohort (siblings of children diagnosed with ASD, n = 188) was examined. Infants were assessed prospectively at 12 and 18 months of age using the clinician administered Autism Observational Scale for Infants (AOSI) and the Autism Parent Screen for Infants (APSI) and underwent a blind independent diagnostic assessment for ASD at 36 months of age. Direct comparison of parent and clinician ratings showed poor agreement on all early behavioral signs, with parent‐reported symptoms being better able to differentiate between children with and without ASD at both 12 and 18 months of age compared to clinician observations during a brief office visit. The results suggest that parents may detect some clinically informative behaviors based on their day‐to‐day observations more readily than do clinicians during brief clinical assessments, a result that needs to be replicated in a non‐sibling cohort. Autism Res2018, 11: 539–547. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: Parents of children at high‐risk of autism spectrum disorder (ASD; have an older sibling with ASD) and clinicians were compared on their reporting of 19 early signs of autism. Direct comparison of parent and clinician ratings showed poor agreement on all early behavioral signs, with parent‐reported symptoms being better able to differentiate between children with and without ASD at both 12 and 18 months of age compared to clinician observations during a brief office visit. This suggests that parents may have important information regarding early development of their high‐risk child. [ABSTRACT FROM AUTHOR]

Despite the strong evidence of executive function (EF) impairment in Autism Spectrum Disorder (ASD), findings in the preschool period have been inconsistent. Whereas some research has supported an early deficit, many studies have not found early differences in EF. The present study assessed simple and complex components of three EF abilities: working memory, inhibition, and shifting, using a novel battery, the Preschool EF Battery (PEFB; Garon, Smith & Bryson, Child Neuropsychology, 20, 713–736, 2014). Previous research has indicated that the PEFB is sensitive to age differences in typically developing (TD) children aged 18–60 months. Current participants were 34 preschoolers (M = 54.79 months) diagnosed with ASD and 255 TD preschoolers (M = 42.98 months). Results indicated significant differences between the two groups in the three EF abilities, but specific findings were moderated by mental and chronological age. The findings highlight the importance of testing simpler EF skills in very young children with ASD. Autism Res2018, 11: 318–330. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: Given that executive functions (EF) have been found to predict various outcomes such as academic ability and occupational success, sensitive early assessment is important. The current study suggests the presence of early EF deficits in preschool children with autism spectrum disorder. The study highlights the importance of considering how EF develops during early life in typically developing children in order to design sensitive EF measures. [ABSTRACT FROM AUTHOR]

Behavioral characteristics of children with autism spectrum disorder (ASD) who respond positively to Pivotal Response Treatment (PRT) have been described previously, based on single‐subject design research. The present study examined several such characteristics, as well as positive affect, as predictors of expressive language (EL) gains in a representative sample of preschoolers with ASD (n = 57) enrolled in a PRT‐based community early intervention program. Children's cognitive ability, positive affect, and levels of appropriate toy contact measured at the start of intervention each contributed significantly to the prediction of EL outcomes. Together these variables accounted for 40% of the total outcome variance. In addition, a profile of increased EL ability, positive affect and appropriate toy contact, and decreased social avoidance and stereotyped and repetitive vocalizations was associated with greater gains during intervention. Results are discussed in relation to their implications for understanding both the variable treatment response documented in children with ASD and how to tailor treatment to optimize individual benefit. Autism Res2018, 11: 153–165. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: The study examined behavior of 57 preschoolers who made the greatest and least gains from 1 year of a community Pivotal Response Treatment program. Using pre‐treatment videos, we saw that children who made the most progress showed more language, positive affect, and appropriate interactions with toys, also less avoidance of people and fewer repetitive vocalizations. Behavior profiles can be used to match treatment to individual children's needs. [ABSTRACT FROM AUTHOR]

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To evaluate the efficacy of the Social ABCs parent-mediated intervention for toddlers with suspected or confirmed autism spectrum disorder (ASD), through a cross-site randomized control trial, sixty-three parent-toddler dyads (toddler age: 16-30 months) were randomized into treatment ( Social ABCs) or control (service-as-usual) conditions. Video data were obtained at three key time-points: Baseline; Post-training (PT; week 12); and Follow-Up (week 24). Analyses included 62 dyads. Treatment allocation significantly accounted for PT gains, all favouring the Treatment group, in (1) child functional vocal responsiveness to parent prompts ( R2 = 0.43, P < .001), (2) child vocal initiations ( R2 = 0.28, P < .001), (3) parent smiling ( R2 = 0.09, P = .017), and (4) fidelity of implementation ( R2 = 0.71, P < .001). A trend was observed for increased social orienting ( R2 = 0.06, P = 0.054); gains in parent smiling significantly predicted increases in child smiling and social orienting. Parents in the treatment condition reported significant gains in self-efficacy following the intervention ( P = 0.009). No differential effects emerged for performance on standardized measures. The Social ABCs is a relatively low-resource, efficacious intervention, with potential to be a cost-effective means of intervening at the first signs of possible ASD. Autism Res 2017, 10: 1700-1711. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Clinical Trial Title: Social ABCs for Toddlers with Signs of Autism Spectrum Disorder: RCT of a Parent-Mediated Intervention http//ClinicalTrials.gov identifier: NCT02428452. [ABSTRACT FROM AUTHOR]

The Social ABCs is a parent-mediated intervention for toddlers with suspected or confirmed autism spectrum disorder (ASD). We undertook a multi-site pilot study to evaluate feasibility and acceptability, and to identify trends in child and parent behavior to inform future research using a larger sample and a rigorous research design. The program involved 12 weeks of parent coaching, followed by 12 weeks' implementation, and 3-month follow-up assessment for 20 parent-toddler dyads (age range: 12-32 months). Parents successfully learned the techniques and rated the intervention as highly acceptable. Paired samples t-tests revealed significant gains in children's functional communication (responsivity, initiations), and language gains (age-equivalents on standardized measures) commensurate with typical developmental rates. Significant increases in shared smiling and social orienting also emerged, but were attenuated at follow-up. Parents' fidelity was positively associated with child responsivity. Training parents as mediators is a feasible and highly acceptable approach that provides a potentially cost-effective opportunity for intensive intervention at a very young age at the first signs of ASD risk. Child and parent gains in several key variables demonstrate the promise of this intervention. Autism Res 2016, 9: 899-912. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder (ASD) are diagnosed, on average, around the age of 4 years. However, previous research has shown that the diagnosis can be made as early as 2 years, and that if the child is seen a year or more later, it is highly likely that the diagnosis will be confirmed. In this study, to examine whether diagnoses made as early as 18 months of age are also 'stable,' we followed a group of younger siblings of children with ASD (who are known to be at higher risk). We also examined whether the age of ASD diagnosis within this high-risk group was related to the severity of children's ASD symptoms or developmental delays. Participants ( n = 381) were seen at three ages: 18 months, 24 months, and 3 years. ASD symptoms, general development, and adaptive functioning were assessed at each time point. Twenty-three children were diagnosed with ASD at 18 months and a total of 61 at 24 months. Of these diagnoses, 19/23 (82.6%) and 56/61 (91.8%), respectively, were confirmed independently at 3 years. However, 45 children were diagnosed with ASD at 3 years who had not been identified at earlier visits. Children diagnosed at 18 months, in comparison to those diagnosed at 24 months, had less advanced language and adaptive skills at 18 months. Children not diagnosed with ASD until 3 years, compared with those diagnosed earlier, had more advanced language and adaptive skills, and milder ASD symptoms. Autism Res 2016, 9: 790-800. © 2015 International Society for Autism Research, Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background The diagnosis of autism spectrum disorder ( ASD) made before age 3 has been found to be remarkably stable in clinic- and community-ascertained samples. The stability of an ASD diagnosis in prospectively ascertained samples of infants at risk for ASD due to familial factors has not yet been studied, however. The American Academy of Pediatrics recommends intensive surveillance and screening for this high-risk group, which may afford earlier identification. Therefore, it is critical to understand the stability of an ASD diagnosis made before age 3 in young children at familial risk. Methods Data were pooled across seven sites of the Baby Siblings Research Consortium. Evaluations of 418 later-born siblings of children with ASD were conducted at 18, 24, and 36 months of age and a clinical diagnosis of ASD or Not ASD was made at each age. Results The stability of an ASD diagnosis at 18 months was 93% and at 24 months was 82%. There were relatively few children diagnosed with ASD at 18 or 24 months whose diagnosis was not confirmed at 36 months. There were, however, many children with ASD outcomes at 36 months who had not yet been diagnosed at 18 months (63%) or 24 months (41%). Conclusions The stability of an ASD diagnosis in this familial-risk sample was high at both 18 and 24 months of age and comparable with previous data from clinic- and community-ascertained samples. However, almost half of the children with ASD outcomes were not identified as being on the spectrum at 24 months and did not receive an ASD diagnosis until 36 months. Thus, longitudinal follow-up is critical for children with early signs of social-communication difficulties, even if they do not meet diagnostic criteria at initial assessment. A public health implication of these data is that screening for ASD may need to be repeated multiple times in the first years of life. These data also suggest that there is a period of early development in which ASD features unfold and emerge but have not yet reached levels supportive of a diagnosis. [ABSTRACT FROM AUTHOR]

Background Differences in how developmental pathways interact dynamically in children with autism spectrum disorder ( ASD) likely contribute in important ways to phenotypic heterogeneity. This study aimed to model longitudinal reciprocal associations between social competence ( SOC) and language ( LANG) pathways in young children with ASD. Methods Data were obtained from 365 participants aged 2-4 years who had recently been diagnosed with an ASD and who were followed over three time points: baseline (time of diagnosis), 6- and 12 months later. Using structural equation modeling, a cross-lagged reciprocal effects model was developed that incorporated auto-regressive (stability) paths for SOC (using the Socialization subscale of the Vineland Adaptive Behavior Scales-2) and LANG (using the Preschool Language Scale-4 Auditory Comprehension subscale). Cross-domain associations included within-time correlations and lagged associations. Results SOC and LANG were highly stable over 12 months. Small reciprocal cross-lagged associations were found across most time points and within-time correlations decreased over time. There were no differences in strength of cross-lagged associations between SOC- LANG and LANG- SOC across time points. Few differences were found between subgroups of children with ASD with and without cognitive impairment. Conclusions Longitudinal reciprocal cross-domain associations between social competence and language were small in this sample of young children with ASD. Instead, a pattern emerged to suggest that the two domains were strongly associated around time of diagnosis in preschoolers with ASD, and then appeared to become more independent over the ensuing 12 months. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective This study provides data on the psychometric properties of a newly developed measure of treatment fidelity in Family-Based Treatment (FBT) for adolescent anorexia nervosa (AN). The Family Therapy Fidelity and Adherence Check (FBT-FACT) was created to evaluate therapist adherence and competency on the core interventions in FBT. Method Participants were 45 adolescents and their families sampled from three randomized clinical trials evaluating treatment for AN. Trained fidelity raters evaluated 19 therapists across 90 early session recordings using the FBT-FACT. They also rated an additional 15 session 1 recordings of an alternate form of family therapy-Systemic Family Therapy for the purpose of evaluating discriminant validity of the FBT-FACT. The process of development and the psychometric properties of the FBT-FACT are presented. Results Overall fidelity ratings for each session demonstrated moderate to strong inter-rater agreement. Internal consistency of the measure was strong for sessions 1 and 2 and poor for session 3. Principal components analysis suggests sessions 1 and 2 are distinct interventions. Discussion The FBT-FACT demonstrates good reliability and validity as a measure of treatment fidelity in the early phase of FBT. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:91-99) [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Determine whether early weight gain predicts full remission at end-of-treatment (EOT) and follow-up in two different treatments for adolescent anorexia nervosa (AN), and to track the rate of weight gain throughout treatment and follow-up. Method Participants were 121 adolescents with AN (mean age = 14.4 years, SD = 1.6), from a two-site (Chicago and Stanford) randomized controlled trial. Adolescents were randomly assigned to family-based treatment (FBT) ( n = 61) or individual adolescent focused therapy (AFT) ( n = 60). Treatment response was assessed using percent of expected body weight (EBW) and the global score on the Eating Disorder Examination (EDE). Full remission was defined as having achieved ≥95% EBW and within one standard deviation of the community norms of the EDE. Full remission was assessed at EOT as well as 12-month follow-up. Results Receiver operating characteristic analyses showed that the earliest predictor of remission at EOT was a gain of 5.8 pounds (2.65 kg) by session 3 in FBT (area under the curve (AUC) = 0.670; p = .043), and a gain of 7.1 pounds (3.20 kg) by session 4 in AFT (AUC = 0.754, p = .014). Early weight gain did not predict remission at follow-up for either treatment. A survival analysis showed that weight was marginally superior in FBT as opposed to AFT (Wald chi-square = 3.692, d f = 1, p = .055). Discussion Adolescents with AN who receive either FBT or AFT, and show early weight gain, are likely to remit at EOT. However, FBT is superior to AFT in terms of weight gain throughout treatment and follow-up. (Int J Eat Disord 2014; 47:124-129) [ABSTRACT FROM AUTHOR]

Objective This study aimed to describe the role of parent alliance in Family-Based Treatment (FBT) for adolescents with anorexia nervosa (AN). Differences between parent and child alliance with the therapist, mothers' and fathers' alliance, and their relationship to outcome were examined. Method Independent observers rated audiotapes of early therapy sessions to assess the therapeutic alliance of parents and adolescents with AN in FBT. Outcome was defined using a previously established cut-point for recovery from AN. Results Mothers' and fathers' alliance scores with the therapist were similar and significantly higher than adolescent alliance scores early in treatment. Combined parent alliance did not predict recovery at the end of treatment. Difference in alliance scores between mothers and fathers, and parents and their child also did not predict recovery at the end of treatment. Conclusions In FBT, parents developed a strong alliance with the therapist early in treatment. These scores were consistent with the focus in FBT on parental management of eating disorder symptoms, as was the fact that alliance between adolescents and therapists was lower. Although parental therapeutic alliance was likely important in FBT, its role in treatment response remains uncertain. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective To examine the predictive value of end of treatment (EOT) outcomes for longer term recovery status. Method We used signal detection analysis to identify the best predictors of recovery based on outcome at EOT using five different eating disorder samples from randomized clinical treatment trials. We utilized a transdiagnostic definition of recovery that included normalization of weight and eating related psychopathology. Results Achieving a body weight of 95.2% of expected body weight by EOT is the best predictor of recovery for adolescents with anorexia nervosa (AN). For adults with AN, the most efficient predictor of weight recovery (BMI > 19) was weight gain to greater than 85.8% of ideal body weight. In addition, for adults with AN, the most efficient predictor of psychological recovery was achievement of an eating disorder examination (EDE) weight concerns score below 1.8. The best predictor of recovery for adults with Bulimia Nervosa (BN) was a frequency of compensatory behaviors less than two times a month. For adolescents with BN, abstinence from purging and reduction in the EDE restraint score of more than 3.4 from baseline to EOT were good predictors of recovery. For adults with binge eating disorder, reduction of the Global EDE score to within the normal range (<1.58) was the best predictor of recovery. Discussion The relationship between EOT response and recovery remains understudied. Utilizing a transdiagnostic definition of recovery, no uniform predictors were identified across all eating disorder diagnostic groups. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013; 46:771-778) [ABSTRACT FROM AUTHOR]

Objective There are limited data supporting specific treatments for adults with anorexia nervosa (AN). Randomized clinical trials (RCTs) for adults with AN are characterized by high attrition limiting the feasibility of conducting and interpreting existing studies. High dropout rates may be related to the inflexible and obsessional cognitive style of patients with AN. This study evaluated the feasibility of using cognitive remediation therapy (CRT) to reduce attrition in RCTs for AN. Method Forty-six participants (mean age of 22.7 years and mean duration of AN of 6.4 years) were randomized to receive eight sessions of either CRT or cognitive behavioral therapy (CBT) over 2 months followed by 16 sessions of CBT for 4 months. Results During the 2-month CRT vs. CBT treatment, rates of attrition were lower in CRT (13%) compared with that of CBT (33%). There were greater improvements in cognitive inefficiencies in the CRT compared with that of the CBT group at the end of 2 months. There were no differences in other outcomes. Discussion These results suggest that CRT is acceptable and feasible for use in RCTs for outpatient treatment of AN. CRT may reduce attrition in the short term. Adequately powered future studies are needed to examine CRT as an outpatient treatment for AN. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013; 46:567-575) [ABSTRACT FROM AUTHOR]

This study examines the relationship between patients' characteristics and the therapeutic alliance in family-based therapy (FBT) and adolescent focused therapy (AFT) for adolescents with anorexia nervosa (AN). Independent observers rated audiotapes of therapy sessions using the working alliance inventory-observer version (WAI-o). Patients' character-istics examined to predict the development of the therapeutic alliance included their socioeconomic characteristics, markers of eating disorder psychopathology and expectancy of their treatment. Baseline scores on the eating disorder examination (EDE) were positively correlated with the alliance early in treatment in FBT but no patients' characteristics were correlated with the alliance in AFT. EDE was a moderator of alliance, with higher baseline EDE scores predicting higher alliance scores in the FBT group than in the AFT group. The results suggest that the therapeutic alliance can be successfully developed with adolescents with AN, even those initially reporting high levels of symptomatology. Adolescents' acknowledgement of their symptoms may be an important factor in their ability to develop an alliance with the therapist. [ABSTRACT FROM AUTHOR]

This study examines the relationship between patients' characteristics and the therapeutic alliance in family-based therapy ( FBT) and adolescent focused therapy ( AFT) for adolescents with anorexia nervosa ( AN). Independent observers rated audiotapes of therapy sessions using the working alliance inventory-observer version ( WAI-o). Patients' characteristics examined to predict the development of the therapeutic alliance included their socioeconomic characteristics, markers of eating disorder psychopathology and expectancy of their treatment. Baseline scores on the eating disorder examination ( EDE) were positively correlated with the alliance early in treatment in FBT but no patients' characteristics were correlated with the alliance in AFT. EDE was a moderator of alliance, with higher baseline EDE scores predicting higher alliance scores in the FBT group than in the AFT group. The results suggest that the therapeutic alliance can be successfully developed with adolescents with AN, even those initially reporting high levels of symptomatology. Adolescents' acknowledgement of their symptoms may be an important factor in their ability to develop an alliance with the therapist. Practitioner points Despite common clinical impressions, it is possible to form a strong therapeutic alliance with adolescents with AN in both family and individual therapy., Adolescents' own reports and perceptions of their eating disorder may be an important factor in their ability to build the therapeutic alliance., Clinical strategies hypothesized to promote a strong therapeutic alliance include the externalization of AN, decreasing blame and a focus on adolescent developmental issues. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the relationship between therapeutic alliance and treatment outcome (remission status) in family-based treatment (FBT) and adolescent-focused therapy (AFT) for adolescents with anorexia nervosa (AN). Method: Independent observers rated audiotapes of early therapy sessions using the Working Alliance Inventory-Observer Version (WAI-o). Outcome was defined using established cut-points for full and partial remission. To control for effects of early symptom improvement, changes in weight- and eating-related psychopathology prior to the alliance session were calculated and entered as a covariate in each analysis. Results: Participants in AFT had significantly higher alliance scores; however, overall scores were high in both therapies. The alliance was not a predictor of full remission for either treatment, though it was a non-specific predictor for partial remission. Discussion: Therapeutic alliance is achievable in adolescents with AN in both AFT and FBT, but demonstrated no relationship to full remission of the disorder. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2013) [ABSTRACT FROM AUTHOR]

Background: Maximizing measurement accuracy is an important aim in child development assessment and research. Parents are essential informants in the diagnostic process, and past research suggests that certain parental characteristics may influence how they report information about their children. This has not been studied in autism spectrum disorders (ASD) to date. We aimed, therefore, to investigate the possible effect that maternal depression might have on a mother's reports of her child's ASD behaviors. Using structural equation modeling, we disaggregated shared from unique variation in the association between latent variable measures of maternal depression and ASD behaviors. Methods: Data were obtained from a study of preschoolers aged 2-4 newly diagnosed with ASD ( n = 214). Information from a parent questionnaire, a semi-structured parent interview, and a semi-structured observational assessment was used to develop a latent variable measure of child ASD behaviors. Mothers reported on their own depression symptoms. We first modeled the covariance between maternal depression and child ASD behavior. Then, to quantify unique variation, we added covariance terms between maternal depression and the residual variation associated with the individual measures of child ASD behaviors. Results: The model demonstrated excellent fit to the underlying data. Maternal self-report of depression symptoms exhibited a significant association with the unique variance of the questionnaire report but not with the latent variable measure of child ASD behavior. A gradient pattern of association was demonstrated between maternal depression and the unique variance of the ASD measures: most strongly for the maternal questionnaire report, more weakly for the maternal semi-structured interview, and to a trivial extent for the observational interview. Conclusions: Parental depression may influence reporting of ASD behaviors in preschoolers. Shared method effects may also contribute to bias. This finding highlights the importance of obtaining multimethod reports of child ASD symptoms. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine the relationship between expressed emotion (EE) and outcome in family-based treatment (FBT) for anorexia nervosa (AN). Method: Eighty-six adolescents with AN participated in an RCT comparing two doses of FBT. Seventy-nine of these patients and their parents participated in a structured interview, from which EE ratings were made at baseline. Parents were compared on five subscales of EE as well as overall level of EE (high vs. low). Results: Overall EE levels were low with 32.9% of families presenting as High EE at baseline. Ratings of baseline warmth for both mothers ( p = .014) and fathers ( p = .037) were related to good outcome at end-of-treatment. Discussion: EE in parents of adolescents with AN is remarkably low. Notwithstanding, parental warmth may be a predictor of good outcome. © 2010 by Wiley Periodicals, Inc. Int J Eat Disord 2010 [ABSTRACT FROM AUTHOR]

The primary purpose of this study was to examine the underlying factor structure of the Parenting Stress Index-Short Form (PSI-SF) in a large cohort of parents of young children with autism spectrum disorder (ASD). A secondary goal was to examine relationships between PSI-SF factors and autism severity, child behavior problems, and parental mental health variables that have been shown to be related to parental stress in previous research. A confirmatory factor analysis (CFA) was used to examine the three-factor structure described in the PSI-SF manual [Abidin, ]: parental distress, parent-child dysfunctional interaction, and difficult child. Results of the CFA indicated that the three-factor structure was unacceptable when applied to the study sample. Thus, an exploratory factor analysis was conducted and suggested a six-factor model as the best alternative for the PSI-SF index. Spearman's correlations revealed significant positive correlations with moderate to large effect sizes between the revised PSI-SF factors and autism severity, externalizing and internalizing child behaviors, and an index of parent mental health. The revised factors represent more narrowly defined aspects of the three original subscales of the PSI-SF and might prove to be advantageous in both research and clinical applications. Autism Res 2011,4:336-346. © 2011 International Society for Autism Research, Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Researchers have recently hypothesized that autism spectrum disorders (ASD) may be partly characterized by physiological over-arousal. One way to assess physiological arousal is through autonomic measures. Here heart period (HP) and parasympathetic activity measured by respiratory sinus arrhythmia (RSA) were examined in adults with ASD and matched controls at rest and during performance of an emotional Stroop task. Resting HP and RSA were lower in adults with ASD than in matched controls, consistent with hypothesized over-arousal in ASD. However, dividing the ASD group on the basis of antipsychotic medication usage revealed that group differences in autonomic arousal may be related to the effects of these medications or their correlates. Autonomic adjustments for Stroop performance were comparable across groups, but in the control group, larger RSA reductions were correlated with faster responding (i.e., better performance). This relation was reversed in the unmedicated ASD group and absent in the medicated ASD group. Findings highlight the importance of considering medication status in the recently burgeoning area of psychophysiological studies of autism. 2011, 4: 98-108. © 2011, International Society for Autism Research, Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

A number of studies suggest anterior cingulate cortex (ACC) abnormalities in autism spectrum disorder (ASD), which might underlie response monitoring and social impairments exhibited by children and adolescents with ASD. The goal of the present study was to extend this work by examining error and correct response monitoring using event-related potentials (ERN, Pe, CRN) and LORETA source localization in high functioning adults with ASD and controls. Adults with ASD showed reduced ERN and Pe amplitudes and reduced rostral ACC activation compared with controls. Adults with ASD also showed less differentiation between error and correct ERP components. Social impairments and higher overall autism symptoms were related to reduced rostral ACC activity at the time of the ERN, particularly in adults with ASD. These findings suggest that reduced ACC activity may reflect a putative brain mechanism involved in the origins and maintenance of social impairments and raise the possibility of the presence of stable brain-behavior relation impairment across development in some individuals with ASD. [ABSTRACT FROM AUTHOR]

Evidence of improved outcomes with early behavioural intervention has placed the early treatment of autism as a health priority. However, long waiting lists for treatment often preclude timely access, raising the question of whether parents could be trained in the interim. Parent training in pivotal response treatment (PRT) has been shown to enhance the communication skills of children with autism. This is typically provided within a 25-hour programme, although less intensive parent training may also be effective. The main objective of the present study was to evaluate the efficacy of brief training in PRT for parents of preschoolers with autism, who were awaiting, or unable to access, more comprehensive treatment. Eight preschoolers with autism and their parents participated in the study. A non-concurrent multiple (across-participants) baseline design was used, in which parents were seen individually for three 2-hour training sessions on PRT. Child and parent outcomes were assessed before, immediately after, and 2 to 4 months following training using standardised tests, questionnaires and behaviour coded directly from video recordings. Overall, children's communication skills, namely functional utterances, increased following training. Parents' fidelity in implementing PRT techniques also improved after training, and generally these changes were maintained at follow-up. A moderate to strong relationship was found between parents' increased ability to implement PRT techniques and improvement in the children's communication skills. Our findings suggest that brief parent training in PRT promises to provide an immediate, cost-effective intervention that could be adopted widely. [ABSTRACT FROM AUTHOR]

Aims To examine the effectiveness of transdermal selegiline for producing cigarette smoking abstinence. Design Adult smokers were randomly assigned to receive selegiline transdermal system (STS) or placebo given for 8 weeks. All participants received cognitive behavior therapy (CBT). Follow-ups were conducted at 25 and 52 weeks. Setting Community smoking cessation clinic. Participants 243 adult smokers (≥18 years of age; ≥10 cigarettes/day). Measures Expired-air carbon monoxide confirmed 7-day point prevalence abstinence. Findings STS was not superior to placebo. More women than men were abstinent at 52 week follow-up (28% vs 16%, P < 0.05). Behavioral activation (BAS) moderated treatment response ( P = 0.01). The survival rate through week 52 for those with high ‘drive’ scores on the BAS was 47% if assigned to selegiline and 34% if assigned to placebo. The survival rate for those with low ‘drive scores’ on the BAS was 35% if assigned to selegiline compared to 53% if assigned to placebo. Conclusion Transdermal selegiline does not appear generally effective in aiding smoking cessation though there may be a selective effect in those smokers with low ‘behavioral activation’. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to chart the developmental trajectories of high-functioning children with autism spectrum disorders (ASD) from early childhood to adolescence using the presence and absence of structural language impairment (StrLI) as a way of differentiating autism from Asperger syndrome (AS). Method: Sixty-four high-functioning children with ASD were ascertained at 4–6 years of age from several different regional diagnostic and treatment centers. At 6–8 years of age, the ADI-R and the Test of Oral Language Development were used to define an autism group (those with StrLI at 6–8 years of age) and an AS group (those without StrLI). Growth curve analysis was then used to chart the developmental trajectories of these children on measures of autistic symptoms, and adaptive skills in communication, daily living and socialization. Results: Differentiating the ASD group in terms of the presence/absence of StrLI provided a better explanation of the variation in growth curves than not differentiating high-functioning ASD children. The two groups had similar developmental trajectories but the group without StrLI (the AS group) was functioning better and had fewer autistic symptoms than the group with StrLI (the autism group) on all measures across time. The differences in outcome could not be explained by non-verbal IQ or change in early language skills. Conclusion: Distinguishing between autism and Asperger syndrome based on the presence or absence of StrLI appears to be a clinically useful way of classifying ASD sub-types. [ABSTRACT FROM AUTHOR]

Objective: To examine the course of Eating Disorder NOS (EDNOS) compared with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Method: Prospective study of 385 participants meeting DSM-IV criteria for AN, BN, BED, and EDNOS at three sites. Recruitment was from the community and specialty clinics. Participants were followed at 6-month intervals during a 4-year period using the Eating Disorder Examination as the primary assessment. Results: EDNOS remitted significantly more quickly that AN or BN but not BED. There were no differences between EDNOS and full ED syndromes, or the subtypes of EDNOS, in time to relapse following first remission. Only 18% of the EDNOS group had never had or did not develop another ED diagnosis during the study; however, this group did not differ from the remaining EDNOS group. Discussion: EDNOS appears to be a way station between full ED syndromes and recovery, and to a lesser extent from recovery or EDNOS status to a full ED. Implications for DSM-V are examined. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2009 [ABSTRACT FROM AUTHOR]

Objective: This study investigated changes in symptom severity and the psychopathology of patients with bulimia nervosa between 1993 and 2003. Method: Pretreatment data of patients diagnosed with bulimia nervosa, collected between 1993 and 1997 from two multisite studies (N = 263), and from 2001 to 2003 from a third multisite study (N = 233) were compared for differences in psychopathology, eating disorder symptoms, and demographic characteristics. Results: There was a significant increase in baseline age between the cohorts (1993M = 28.7 ± 7.9, 2001M = 30.3 ± 8.7, p = 0.036) together with a decrease in personality disorders and in several aspects of eating disorder psychopathology. After controlling for age however, significant pretreatment differences were found only in the restraint subscale on the EDE. Conclusion: Results suggest that the presentation of individuals with bulimia nervosa has changed between 1993 and 2003, in that participants were older and demonstrated less dietary restraint. Hence, comparisons between samples and treatment trials over time must be made with caution. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to explore the predictors of dropout and remission in the treatment of adolescent anorexia nervosa (AN) using family therapy. Method: Data derived from a randomized clinical trial comparing short and long term family therapy for adolescents with AN were used. A rotated component analysis was employed to reduce the number of variables and to address problems of collinearity and multiple testing. Dropout was defined as participating in less than 80% of the assigned therapy. Participants were classified as remitted if they obtained an ideal body weight greater than 95% and a global eating disorder Examination score within two standard deviations of community norms at the end of 12 months. Results: Co-morbid psychiatric disorder and being randomized to longer treatment predicted greater dropout. The presence of co-morbid psychiatric disorder, being older, and problematic family behaviors led to lower rates of remission. A reduction of child behavioral symptoms, a decline in problematic family behaviors, and early weight gain were all within treatment changes that increased the chance of remission. Conclusion: Co-morbid psychiatric disorder, family behaviors, and early response to treatment are important factors when predicting dropout and remission in family therapy for adolescent AN. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006; 39:639–647 [ABSTRACT FROM AUTHOR]

Objective The current study examines diet aid use among college women at risk for eating disorders and explores characteristics associated with diet aid use. Method Participants were 484 college women <30 years from 6 universities in the San Francisco Bay Area (SF) and San Diego who were at risk for developing eating disorders. A checklist assessed diet pill, fat blocker, diuretic, laxative, and other diet aid use over the past 12 months. Results Thirty-two percent of the college women reported using a diet aid. Diet aid use was double the rate in San Diego (44%) compared with SF (22%) (p = .000). Weight and shape concerns were higher among diet aid users than among nonusers across sites. Conclusion A significant number of college women at risk for eating disorders are using diet aids. We recommend that clinicians inquire about diet aid use among college-aged patients. © 2006 by Wiley Periodicals, Inc. (Int J Eat Disord 2006) [ABSTRACT FROM AUTHOR]

Background: The Restricted, Repetitive Behaviours and Interests (RRBIs) are represented in the DSM-IV and measured by the Autism Diagnostic Interview-Revised (ADI-R) as one of the three homogeneous symptom categories of Pervasive Developmental Disorders. Although this conceptualisation is well accepted in the field, the grouping of symptoms is based primarily on clinical judgment rather than on empirical evidence. Methods: The objective of this study was to examine the factor structure of the RRBI domain of autism. Eleven items from this domain of the ADI-R were used in a Principal Components Analysis (PCA). Our sample consisted of 339 individuals with a Best Estimate diagnosis of Pervasive Developmental Disorder (PDD). Results: Findings indicate that the RRBI domain is composed of two distinct factors or dimensions : Insistence on Sameness (IS) and Repetitive Sensory and Motor Behaviours (RSMB). RSMB is negatively correlated with adaptive skills; that is, lower functioning individuals tend to have higher levels of repetitive sensory and motor behaviours. On the other hand, IS is positively correlated with autistic symptoms in the communication and language domain. Further analyses suggest moderate familial aggregation among affected sibling pairs within the IS but not the RSMB factor. Conclusions: These results provide evidence for the heterogeneity of the RRBI domain of the ADI-R in terms of both clinical presentation and other correlates. In addition, the IS factor seems to be under familial (presumably genetic) control, while RSMB appears to simply reflect variation in developmental level. [ABSTRACT FROM AUTHOR]

Objective The current study sought to determine whether there is an optimal pattern of eating leading to cessation of binge eating and purging in bulimic women. Method Data on the number of meals and snacks consumed were obtained from the Eating Disorders Examination (EDE) pretreatment and posttreatment, for individuals participating in a randomized controlled study comparing cognitive-behavioral therapy and interpersonal therapy. Records were available for 158 participants. Results The numbers of meals and snacks eaten from pretreatment to posttreatment increased significantly. A pattern of eating with at least 80 meals combined with at least 21 afternoon snacks within a 28-day period was associated with an abstinence rate of 70%. In contrast, for subjects having 72–80 meals, those having greater than 11 evening snacks have an abstinence rate of 4%. Conclusion The critical elements of the pattern of eating related to abstinence appear to be the total number of meals consumed and the timing of snacks. © 2005 by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

In the interest of more systematically documenting the early signs of autism, and of testing specific hypotheses regarding their underlying neurodevelopmental substrates, we have initiated a longitudinal study of high-risk infants, all of whom have an older sibling diagnosed with an autistic spectrum disorder. Our sample currently includes 150 infant siblings, including 65 who have been followed to age 24 months, who are the focus of this paper. We have also followed a comparison group of low-risk infants. Our measures include a novel observational scale (the first, to our knowledge, that is designed to assess autism-specific behavior in infants), a computerized visual orienting task, and standardized measures of temperament, cognitive and language development. Our preliminary results indicate that by 12 months of age, siblings who are later diagnosed with autism may be distinguished from other siblings and low-risk controls on the basis of: (1) several specific behavioral markers, including atypicalities in eye contact, visual tracking, disengagement of visual attention, orienting to name, imitation, social smiling, reactivity, social interest and affect, and sensory-oriented behaviors; (2) prolonged latency to disengage visual attention; (3) a characteristic pattern of early temperament, with marked passivity and decreased activity level at 6 months, followed by extreme distress reactions, a tendency to fixate on particular objects in the environment, and decreased expression of positive affect by 12 months; and (4) delayed expressive and receptive language. We discuss these findings in the context of various neural networks thought to underlie neurodevelopmental abnormalities in autism, including poor visual orienting. Over time, as we are able to prospectively study larger numbers and to examine interrelationships among both early-developing behaviors and biological indices of interest, we hope this work will advance current understanding of the neurodevelopmental origins of autism. [Copyright &y& Elsevier]

The present study examined the disengage and shift operations of visual attention in young children with autism. For this purpose, we used a simple visual orienting task that is thought to engage attention automatically. Once attention was first engaged on a central fixation stimulus, a second stimulus was presented on either side, either simultaneously or successively. Latency to begin an eye movement to the peripheral stimulus served as the main dependent measure. The two stimulus conditions (simultaneous and successive) provided independent measures of disengaging and shifting attention, respectively. Performance of children with autism was compared to that of children with Down syndrome and a normal group. The main finding was that relative to both comparison groups, children with autism had marked difficulty in disengaging attention. Indeed, on 20% of trials they remained fixated on the first of two competing stimuli for the entire 8-second trial duration. Evidence is also provided for a more subtle problem in executing rapid shifts of attention. Our findings on disengagement in autism parallel those reported in normal 2-month-olds, in whom attention has been described as ‘obligatory’. Discussion focuses on the potential role of general versus domain-specific processes in producing some of the core features of autism. [ABSTRACT FROM AUTHOR]

Objectives This study explores whether asking minors about risky weight control behaviors and attitudes increases the frequency of those behaviors and attitudes. Methods Participants were 115 sixth-grade girls who responded to questions on risky weight control behaviors and attitudes at baseline and at 12-month follow-up. An additional 107 girls, who had not been part of the baseline, provided data only at follow-up. The two groups were compared on risky weight control behaviors and attitudes at follow-up using chi-square analyses, Mann-Whitney U tests, Cohen's effect sizes, and odds ratios. Results No evidence of a negative effect in the twice-assessed group was found. All rates decreased from baseline to follow-up. Conclusions There is only minimal risk and perhaps even some benefit of asking questions about risky weight control behaviors and attitudes. Implications for determining appropriate consent procedures are discussed. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: 251–254, 2003. [ABSTRACT FROM AUTHOR]

Compares the Eating Disorder Examination (EDE) with the self-report version (EDE-Q) in a population of adolescents with anorexia nervosa. Advantages of using self-report in eating disorder research; Analysis of the EDE and EDE-Q among male and female obese gastric bypass surgery candidates; Results of a study on the EDE and EDE-Q within a binge-eating disorder population.

Objective: To determine the risk of the lesser variant (or PDD-like traits) in the biological and nonbiological second- and third-degree relatives of PDD probands using a screening questionnaire and to investigate the extent to which the risk of the lesser variant differs according to various characteristics of the proband. Method: The sample consists of a series of 34 nuclear families with 2 affected PDD children (multiplex, MPX), 44 families with a single PDD child (simplex, SPX), and 14 families who adopted a PDD child. Data on characteristics of the lesser variant in 1362 biological and 337 nonbiological second- and third-degree relatives were collected from parents by telephone interview and from several maternal and paternal relatives by questionnaire. Results: All components of the lesser variant were more common in biological relatives (BR) than nonbiological relatives (NBR), confirming the familial aggregation of the traits. Proband characteristics associated with an increased risk of the lesser variant in relatives were a higher level of functioning and coming from a MPX family. Conclusions: These findings on the familial aggregation of the lesser variant suggest that the genes for PDD also confer susceptibility to the lesser variant and that PDD may be a genetically heterogeneous disorder. [ABSTRACT FROM AUTHOR]

This article presents a study, which examined sex differences in depression and the method of administering the Beck Depression Inventory (BDI). BDI interim reliability was comparable across the two sexes and across different methods of test administration, and no evidence was found in any of the experiments or in all four combined that depression is more severe or common in females. It was found that for both sexes responses to the BDI did not vary with the sex of the examiner. It is suggested that sex differences in depression have more to do with the population sampled than with the method of administering tests such as the BDI. Indeed, responses to the BDI appear essentially unaffected by the method of administration.

This study explored the claim that superior disembedding performance in autism reflects 'less capture by meaning' and/or reduced 'central coherence' [Shah & Frith, Journal of Child Psychology & Psychiatry, 24, 613-620 (1983); Shah & Frith, Journal of Child Psychology & Psychiatry, 34, 1351-1364 (1993)]. Meaningless as well as meaningful disembedding contexts were used, and memory for contextual information was examined. Neither qualitative (search strategy) nor quantitative (RT or accuracy) data indicated that high-functioning individuals with autism/PDD were superior to younger, developmentally matched controls. For both groups, disembedding was slowest from meaningful contexts, which generally were remembered best. No evidence was provided for 'less capture by meaning' or reduced 'central coherence' in autism/PDD, raising the possibility that earlier findings reflect a developmental, rather than a stable autism-specific, phenomenon. [ABSTRACT FROM AUTHOR]

This report describes an epidemiological investigation of the autistic syndrome using new research diagnostic criteria (Denckla, 1986). The focus here is on the methods of screening and follow-up, and on a description of the cases identified within a circumscribed region of Nova Scotia. Autism, as defined by social deviance, language impairment and repetitive or ritualistic behaviours, has a prevalence of 10 per 10,000 and a male to female ratio of 2.5 : 1. These findings are discussed relative to those reported previously. [ABSTRACT FROM AUTHOR]

We provide an overview of research on the epidemiology of autism and related pervasive developmental disorders (PDDs). First, we provide data on the prevalence of autism, which now is estimated to be considerably higher than previously documented. Next, we focus on characteristics associated with autism, including psychosocial correlates, as well as associated physical and medical/psychiatric conditions. In this context, special consideration is given to the coexistence of autism and mental retardation, and to associated conditions that might be the most informative in advancing our understanding of the neurobiology and neuropsychology of autism. Data on outcome are also discussed, with special reference to early intervention and to empirically supported methods. We end by identifying potentially fruitful directions for future epidemiological research on autism/PDD, and by outlining implications of what already is known for the planning and delivery of services for this unique population. MRDD Research Reviews 1998;4:97–103. © 1998 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Examines the association of weight concerns with potential risk factors for the development of eating disorders. Development of a risk factor survey; Importance of peer influences on weight; Goal of trying to look like girls/women on television or in magazines; Body mass index.