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The present study compared parent ratings to self-report ratings of depression, anxiety, hyperactivity, attention problems, and atypical behaviors in youth with high-functioning autism spectrum disorder (HFASD) and typically developing (TD) controls. Measures included parent and self-report forms from the Behavioral Assessment System for Children-Second Edition (BASC-2), and self-report forms from the Children's Depression Inventory (CDI) and the Multidimensional Anxiety Scale for Children (MASC). Results across all five BASC-2 scales indicated parent ratings for the HFASD condition were significantly higher than HFASD self-ratings, and were significantly higher than parent and self-ratings from the TD condition. In addition, average self-report scores did not differ significantly between HFASD and TD conditions on any of the BASC-2 scales, the CDI, or the MASC.

Restricted interests are an established diagnostic symptom of autism spectrum disorder. While there is considerable evidence that these interests have maladaptive consequences, they also provide a range of benefits. This article introduces a new instrument, the Survey of Favorite Interests and Activities, and uses it to examine the nature of restricted interests in autism spectrum disorder. Respondents report substantial benefits of restricted interests as well as areas of difficulty. The Survey of Favorite Interests and Activities assesses Social Flexibility, Perseveration, Respondent Discomfort, Adaptive Coping, and Atypicality. All scales have Cronbach’s α > 0.70. Age and socioeconomic status have little effect on Survey of Favorite Interests and Activities scales; nor does gender with the exception of interest Atypicality. The expected pattern of correlations with existing scales was found. Research and clinical implications are discussed.

In answer to the call for improved accessibility of neuropsychological services to the international community, the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS; MS) was validated in multiple, non-English-speaking countries. It was created to monitor processing speed and learning in MS patients, including abbreviated versions of the Symbol Digit Modalities Test, California Verbal Learning Test, 2nd Edition, and the Brief Visuospatial Memory Test, Revised. The objective of the present study was to examine whether participant nationality impacts performance above and beyond common demographic correlates.We combined published data-sets from Argentina, Brazil, Czech Republic, Iran, and the U.S.A. resulting in a database of 1,097 healthy adults, before examining the data via multiple regression.Nationality significantly predicted performance on all three BICAMS tests after controlling for age and years of education. Interactions among the core predictor variables were non-significant.We demonstrated that nationality significantly influences BICAMS performance and established the importance of the inclusion of a nationality variable when international norms for the BICAMS are constructed.

The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is an international assessment tool for monitoring cognitive function in multiple sclerosis (MS) patients. BICAMS comprises the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test - Second Edition (CVLT II) and the Brief Visuospatial Memory Test - Revised (BVMT-R). Our objective was to validate and assess the reliability of BICAMS as applied in Argentina and to obtain normative data in Spanish for this population.The sample composed of 50 MS patients and 100 healthy controls (HC). In order to test its reliability, BICAMS was re-administered in a subset of 25 patients.The sample's average age was 43.42 ± 10.17 years old, and average years of schooling were 14.86 ± 2.78. About 74% of the participants were women. The groups did not differ in age, years of schooling, or gender. The MS group performed significantly worse than the HC group across the three neuropsychological tests, yielding the following Cohen's d values: SDMT: .85; CVLT I: .87; and BVMT-R: .40. The mean raw scores for Argentina normative data were as follows: SDMT: 56.71 ± 10.85; CVLT I: 60.88 ± 10.46; and BVMT-R: 23.44 ± 5.84. Finally, test-retest reliability coefficients for each test were as follows: SDMT: r = .95; CVLT I: r = .87; and BVMT-R: r = .82.This BICAMS version is reliable and useful as a monitoring tool for identifying MS patients with cognitive impairment.

This study compared speech samples of 29 boys aged 6–13 with high-functioning autism spectrum disorder (HFASD) to those of 29 typically developing (TD) boys matched on age and ethnicity. Ten listeners blind to speakers’ diagnoses rated speech samples for nasality and reported their perceptions of the speaker on a 6-point Likert-type scale. Results indicated significantly greater listener-perceived nasality in the HFASD than the TD group. Listeners rated the HFASD group significantly higher than the TD group on negative socially relevant adjectives, a finding which was mediated by nasality. In addition, compared to TD speakers, speakers with HFASD were rated lower on dominance and perceived age, as well as higher on perceived disability.

We endeavored to clarify how distinct co-occurring symptoms relate to the presence of negative work events in employed multiple sclerosis (MS) patients. Latent profile analysis (LPA) was utilized to elucidate common disability patterns by isolating patient subpopulations.Samples of 272 employed MS patients and 209 healthy controls (HC) were administered neuroperformance tests of ambulation, hand dexterity, processing speed, and memory. Regression-based norms were created from the HC sample. LPA identified latent profiles using the regression-based z-scores. Finally, multinomial logistic regression tested for negative work event differences among the latent profiles.Four profiles were identified via LPA: a common profile (55%) characterized by slightly below average performance in all domains, a broadly low-performing profile (18%), a poor motor abilities profile with average cognition (17%), and a generally high-functioning profile (9%). Multinomial regression analysis revealed that the uniformly low-performing profile demonstrated a higher likelihood of reported negative work events.Employed MS patients with co-occurring motor, memory and processing speed impairments were most likely to report a negative work event, classifying them as uniquely at risk for job loss.

This replication randomized clinical trial examined the efficacy of a comprehensive psychosocial intervention for children aged 7 to 12 years with high-functioning autism spectrum disorders (HFASDs). Participants were randomly assigned to treatment or wait-list conditions. Treatment included instruction and therapeutic activities targeting social skills, face-emotion recognition, interest expansion, and interpretation of non-literal language. A response-cost program was used to reduce problem behaviors and increase skills acquisition. Significant treatment effects were found for five of seven primary outcome measures (parent ratings and direct child measures). Secondary measures (i.e., staff ratings) corroborated gains reported by parents. Children maintained social gains 2 to 3 months post-treatment. High levels of parent, child, and staff satisfaction were found, along with high levels of treatment fidelity. Standardized effect size estimates were predominantly in the medium and large ranges for significant outcome variables.

Multiple sclerosis (MS) causes cognitive impairment including slowed processing speed and problems with learning and memory. Stimulants are attractive candidates for improving mental speed but carry risk of addiction and other adverse behavioral effects. Lisdexamfetamine dimesylate (LDX) is a D-amphetamine prodrug currently approved for attention deficit (hyperactivity) disorder with the potential to be better tolerated due to its prolonged clinical effect. This phase II placebo-controlled, double-blind study aimed to assess the safety and efficacy of LDX in cognitively impaired MS patients. Subjects were patients with clinically definite MS, aged 18-56 years, and impaired on either of two primary outcomes: the Symbol Digit Modalities Test (SDMT) or the Paced Auditory Serial Addition Test (PASAT). Both SDMT and PASAT are measures of cognitive processing speed. Of 174 MS patients screened, 63 were randomized to 30 mg of LDX or placebo in a 2:1 fashion; the dose was increased as tolerated to 70 mg over 4 weeks and then maintained for another 4 weeks. Secondary outcomes were the Brief Visuospatial Memory Test Revised (BVMTR), the California Verbal Learning Test 2nd edition (CVLT2), both measures of episodic memory, and the Behavioral Rating Inventory of Executive Function for adults (BRIEF-A), a self-report measure of executive function. Fatigue and depression were also evaluated. There was significant improvement in the SDMT score (+4.6 vs. +1.3) and CVLT2 score (+4.7 vs. -0.9) in the LDX group compared with the placebo group among the 49 completers. There was no change on the other outcomes. A high proportion of both LDX-treated and placebo-treated subjects reported adverse events (73.5 % vs. 68.4 %). However, there were no serious adverse events noted in the study. These preliminary data indicate that LDX has the potential to be an efficacious treatment for MS patients with cognitive impairment.

This brief report investigated coping strategies and their perceived effectiveness in response to a social stressor for 7–12 year olds with high-functioning autism spectrum disorders (HFASDs). Ninety-eight participants completed a self-report coping scale in response to a self-identified socially stressful situation. Responses yielded three categories of use and perceived effectiveness: (1) strategies used frequently and viewed as effective, (2) strategies not used frequently and not perceived as effective, and (3) strategies used frequently but not perceived as effective. Respondents reported high frequency use and high perceived effectiveness of six strategies that are generally considered as positive/engagement oriented coping. They also indicated low frequency use and low perceived effectiveness of five strategies broadly regarded as negative and avoidant/disengagement coping. The last cluster of four strategies, identified as frequently used but not effective, consisted of strategies less clearly categorised as positive/engaged vs. negative/disengaged. Implications for future research and clinical considerations are proposed.

Fatigue and depression have been shown to be significant problems in children with multiple sclerosis. The rate at which these conditions occur in children with other acquired demyelinating syndromes is unknown. In this cross-sectional study, the authors evaluated 49 children with demyelinating disorders (multiple sclerosis and acute disseminated encephalomyelitis) and 92 healthy controls for depression and/or fatigue using the Behavior Assessment System for Children, Second Edition behavior and mood rating scale and Varni PedsQL Multidimensional Fatigue Scale. The parents of acquired demyelinating syndrome patients were more likely to report elevated depressive symptoms (30.8% vs 10.8%, P = .008). Elevated parent and self-reported total fatigue (25% vs 0%, P < .001, 26.7% vs 8.6%, P = .024) was seen in the patient cohort. The authors conclude that fatigue and depression are far more common in children with acquired demyelinating syndromes than in controls. Clinical attention to and implementation of effective therapies oriented toward these conditions in children with acquired demyelinating syndromes is needed.

This study investigated the relationships among stress, intrapersonal resiliency factors (self-esteem, locus of control, and optimism) and quality of life [QOL] (physical health and mental health) among caregivers of children with high functioning autism spectrum disorders (HFASDs). Participants consisted of 113 caregivers of children with HFASDs (males = 38.1%, females = 61.9%; age range = 27–62; 93.6% Caucasians) and 47 caregivers of typically developing children (males = 29.8%; females = 70.2%; age range = 30–56; 93.3% Caucasians). They completed a set of self-rating surveys on perceived locus of control, self-esteem, optimism, and QOL. Within-group inferential statistical analyses were applied. For the HFASD group analyses, two simultaneous regression analyses were used to study the independent effects of the three intrapersonal variables on the physical health and mental health QOL of the caregivers. Intrapersonal factors predicted self-reported mental health QOL but not physical health QOL in caregivers of children with HFASDs.

Background: Cognitive impairment is common in multiple sclerosis (MS), but is seldom assessed in clinical trials investigating the effects of disease-modifying therapies. The Symbol Digit Modalities Test (SDMT) is a particularly promising tool due to its sensitivity and robust correlation with brain magnetic resonance imaging (MRI) and vocational disability. Unfortunately, there are no validated alternate SDMT forms, which are needed to mitigate practice effects. Objective: The aim of the study was to assess the reliability and equivalence of SDMT alternate forms. Methods: Twenty-five healthy participants completed each of five alternate versions of the SDMT – the standard form, two versions from the Rao Brief Repeatable Battery, and two forms specifically designed for this study. Order effects were controlled using a Latin-square research design. Results: All five versions of the SDMT produced mean values within 3 raw score points of one another. Three forms were very consistent, and not different by conservative statistical tests. The SDMT test–retest reliability using these forms was good to excellent, with all r values exceeding 0.80. Conclusions: For the first time, we find good evidence that at least three alternate versions of the SDMT are of equivalent difficulty in healthy adults. The forms are reliable, and can be implemented in clinical trials emphasizing cognitive outcomes.

Many studies have shown that multiple sclerosis (MS) has a significant impact on patient health-related quality of life (HRQOL), but the relative contributions of physical versus cognitive disability are not well established. Most studies have relied on HRQOL outcomes that depend largely on patient mood, life satisfaction, and personal happiness. The Sickness Impact Profile (SIP) is a measure of HRQOL known for its relatively strong emphasis on task completion and activities of daily living. As such, the SIP may be less influenced by depression. We sought to determine the relative influence of physical disability and cognition, above and beyond demographic and disease variables, in predicting HRQOL. Patients (n = 132) and healthy controls (n = 26) underwent complete neuropsychological evaluation using the Minimal Assessment of Cognitive Function in MS (MACFIMS) battery and a series of self-report measures assessing depression, fatigue, and HRQOL. The SIP was also administered. Correlation analysis and group comparisons revealed significant associations between cognition and HRQOL outcomes. Logistic regression models comparing the Expanded Disability Status Scale (EDSS) and cognitive tests in predicting poor physical HRQOL retained both EDSS and Symbol Digit Modalities Test (SDMT) performance, while models predicting poor psychosocial and poor overall HRQOL retained only the SDMT. These findings support cognition as a significant predictor of overall HRQOL, psychosocial HRQOL, and, interestingly, physical HRQOL.

The Brief Visuospatial Memory Test - Revised (BVMTR) and the Symbol Digit Modalities Test (SDMT) oral-only administration are known to be sensitive to cerebral disease in adult samples, but pediatric norms are not available. A demographically balanced sample of healthy control children (N = 92) ages 6-17 was tested with the BVMTR and SDMT. Multiple regression analysis (MRA) was used to develop demographically controlled normative equations. This analysis provided equations that were then used to construct demographically adjusted z-scores for the BVMTR Trial 1, Trial 2, Trial 3, Total Learning, and Delayed Recall indices, as well as the SDMT total correct score. To demonstrate the utility of this approach, a comparison group of children with acute disseminated encephalomyelitis (ADEM) or multiple sclerosis (MS) were also assessed. We find that these visual processing tests discriminate neurological patients from controls. As the tests are validated in adult multiple sclerosis, they are likely to be useful in monitoring pediatric onset multiple sclerosis patients as they transition into adulthood.

Background: Children with multiple sclerosis (MS) can suffer significant cognitive deficits. This study investigates the sensitivity and validity in pediatric MS of two visual processing tests borrowed from the adult literature, the Brief Visuospatial Memory Test-Revised (BVMTR) and the Symbol Digit Modalities Test (SDMT). Objective: To test the hypothesis that visual processing is disproportionately impacted in pediatric MS by comparing performance with that of healthy controls on the BVMTR and SDMT. Methods: We studied 88 participants (43 MS, 45 controls) using a neuropsychological assessment battery including measures of intelligence, language, visual memory, and processing speed. Patients and demographically matched controls were compared to determine which tests are most sensitive in pediatric MS. Results: Statistically significant differences were found between the MS and control groups on BVMTR Total Learning ( t (84) = 4.04, p Conclusions: This study found that BVMTR and SDMT may be useful in assessing children and adolescents with MS.

The purpose of this study was to: (1) examine symptom levels of anxiety and depression in children with high-functioning autism spectrum disorders (HFASDs) compared with matched control children using child self-reports and parent ratings; and (2) examine source differences within the two condition groups. An overall multivariate effect indicated significantly elevated depression and anxiety symptoms for children with HFASDs based on parent reports; however no significant between-group differences based on child self-reports. Within-condition source comparisons (parent vs. child) revealed a significant multivariate effect indicating a significant difference in symptoms of depression and anxiety for the HFASD group but none for the control. Correlations between parent and child reports for the HFASD group suggested some positive association between child-reports and parent-reports for depressive symptoms only; however, the difference in average scores reflected a substantial discrepancy in the magnitude of symptoms by rater. Implications for clinical assessment and future research are provided.

The visual-motor skills of 60 children with high-functioning autism spectrum disorders (HFASDs) and 46 typically developing children were assessed using the Bender Visual-Motor Gestalt Test— Second Edition (BG-II) and Beery-Buktenica Developmental Test of Visual-Motor Integration, Fifth Edition (VMI-V). Within-group comparisons yielded substantive mean differences between the BG-II Copy score and VMI-V composite,Visual Perception and Motor Coordination sections of the VMI-V, and Copy and Recall sections of the BG-II, in both samples. Between-groups differences were assessed in a subsample of 27 participants from each group matched on age, gender, ethnicity, and parent education. After statistically controlling for IQ, the HFASD group scored significantly lower than the typically developing group on the two scores from each test with greater motor involvement. Intratest and intertest correlations were similar across the two samples. Correlations between the BG-II Copy score and VMI-V composite were .55 for the HFASD and .48 for the typically developing sample.

The physical and mental health-related quality of life (QOL) of 89 parents of children with high-functioning autism spectrum disorders (HFASDs) was compared to the health-related QOL of 46 parents of children without disabilities. Parents completed a packet of surveys measuring demographics, parenting stress, coping, resources, and QOL. Results of t tests showed significant differences between the two groups for all variables. Hierarchical regression analyses indicated that for parents of children with HFASDs, demographics and psychosocial variables accounted for a significant amount of variance for physical health-related QOL, with income, number of children, and stress being significant variables. Demographics and psychosocial variables also accounted for a significant amount of variance for parents’ mental health-related QOL, with income and stress being significant variables.

BASC-2 PRS profiles of 62 children with high-functioning autism spectrum disorders (HFASDs) were compared with those of 62 typically-developing children matched by age, gender, and ethnicity. Results indicated that, except for the Somatization, Conduct Problems, and Aggression scales, significant differences were found between the HFASD and typically-developing groups on all PRS scores. Mean HFASD scores were in the clinically significant range on the Behavioral Symptoms Index, Atypicality, Withdrawal, and Developmental Social Disorders scales. At-risk range HFASD means were obtained on the Adaptive Skills composite, all adaptive scales, remaining content scales (except Bullying), and Hyperactivity, Attention Problems, and Depression clinical scales. Screening indices suggested that the Developmental Social Disorders scale was highly effective in differentiating between the two groups.

Objective: The Brief Visuospatial Memory Test-Revised (BVMT-R) is one of the most widely used tests for the assessment of learning and memory in the visual/spatial domain. The aim of this study was to use multiple regression to derive normative data for the use of BVMT-R in an Italian population. Method: We employed a regression-based norms procedure to maximally utilize a relatively small sample while controlling for a variety of demographic factors in addition to age. Additionally, we used these norms to compare the performance of Italian healthy controls with patients diagnosed with multiple sclerosis (MS), thereby providing evidence of the method’s validity. Results: A total of 200 healthy volunteers and 70 MS patients participated in this study and completed the BVMT-R according to the published procedures. Regression-based norms were generated for the Italian sample and are presented herein. Conclusions: Using these norms, the performance of the MS patients was found to be significantly wors...

The Gilliam Autism Rating Scale-Second Edition (GARS-2) is a widely used screening instrument that assists in the identification and diagnosis of autism. The purpose of this study was to examine the factor structure, internal consistency, and screening sensitivity of the GARS-2 using ratings from special education teaching staff for a sample of 240 individuals with autism or other significant developmental disabilities. Exploratory factor analysis yielded a correlated three-factor solution similar to that found in 2005 by Lecavalier for the original GARS. Though the three factors appeared to be reasonably consistent with the intended constructs of the three GARS-2 subscales, the analysis indicated that more than a third of the GARS-2 items were assigned to the wrong subscale. Internal consistency estimates met or exceeded standards for screening and were generally higher than those in previous studies. Screening sensitivity was .65 and specificity was .81 for the Autism Index using a cut score of 85. Based on these findings, recommendations are made for instrument revision.

The National Multiple Sclerosis Society Consensus Neuropsychological Battery for Pediatric Multiple Sclerosis (NBPMS) was designed to detect cognitive impairment in children and adolescents with multiple sclerosis. One weakness of the battery is the reliance on published manual-based normative samples varying in size and quality. These primary sources base interpretation on discrete age bands, a practice which may be particularly problematic during periods of rapid development in childhood and adolescence. A further impediment to valid NBPMS interpretation is the lack of control for demographic factors other than age. We endeavored to develop regression-based norms for the NBPMS by gathering a demographically balanced sample of 102 healthy control children and using their performance to derive normalization, controlling for multiple demographic variables (i.e., age, age(2), gender, parent education). The regression-based normative equations were applied to the performance of 51 children with MS. For many of the major test scores, the regression-based norms more readily detected impairment. As in the case of adult MS, these results indicate that regression-based norms offer interpretive benefits over their manual-based counterparts.

This RCT examined the efficacy of a manualized social intervention for children with HFASDs. Participants were randomly assigned to treatment or wait-list conditions. Treatment included instruction and therapeutic activities targeting social skills, face-emotion recognition, interest expansion, and interpretation of non-literal language. A response-cost program was applied to reduce problem behaviors and foster skills acquisition. Significant treatment effects were found for five of seven primary outcome measures (parent ratings and direct child measures). Secondary measures based on staff ratings (treatment group only) corroborated gains reported by parents. High levels of parent, child and staff satisfaction were reported, along with high levels of treatment fidelity. Standardized effect size estimates were primarily in the medium and large ranges and favored the treatment group.