-
[show abstract]
[hide abstract]
ABSTRACT: The self-regulation systems develop during early childhood resulting from the meeting of the constitutional characteristics of the child, his/her adaptability and environmental responses. The failure of the intersection of these dimensions leads to the onset of symptoms that can seriously affect the child's behavior and his/her relationship. Regulatory disorders of sensory processes (DR) were identified as independent nosographic category in the "Diagnostic Classification 0-3". The aim of this study was the description of the clinical features of a group of children for whom a diagnosis of regulatory disorders was made before the three years, and their development at school age.
The sample was composed of 28 children, 22 males and 6 females, selected from a group of 60 children, with a mean age at T0 of 34.8 months (range 14-56 months). The clinical reassessment was conducted after five years (T1), with a children's mean age of 103.5 months (range 71-150 months).
Approximately 40% of school age participants shows no longer any disturbance, while the remaining % shows a very heterogeneous spectrum of disorders.
The diagnosis of DR is sensitive enough to detect in infancy a wide range of developmental difficulties, but it is quite specific and relatively predictive about the child's subsequent development. Retrospectively the entire diagnostic profile provides more information than the primary diagnosis and the greatest impairment of the different dimensions explored predicts a more severe evolution.
Minerva pediatrica 06/2012; 64(3):289-301.
-
[show abstract]
[hide abstract]
ABSTRACT: General movements (GMs) are a distinct movement pattern carried out spontaneously without external stimulation and seen in fetuses of 9 weeks gestational age till 21 weeks postterm. GMs are helpful in the early diagnosis of an impaired central nervous system and the specific prediction of later neurological deficits. Autism spectrum disorder (ASD) is a neurodevelopmental disorder involving a life-long deficit in several aspects of the social and communicative behavior. Recently there appeared studies proving that children with ASD demonstrate disorders of motor development. To detect whether abnormalities in spontaneous motor activity can be observed already in the first months of life in infants with ASD. A retrospective study was performed by analyzing the family videos provided by parents of 20 children (male 17, female 3) later diagnosed as ASD. Home videos provided by parents of a control group of healthy children (n=20; male 10, female 10) matched for age with the ASD subjects and recorded in similar conditions were also analysed. In total 70 sequences were studied. Two independent observers, blind of the infants' outcome (ASD or normal), assessed the cases applying a global and a more detailed assessment of GMs. Hence, the age-specific GM pattern (normal or abnormal) as well as motor optimality scores were determined for each video sequence. Cohen kappa was 0.614. During the writhing movement period 70.0% sequences of infants with ASD showed poor repertoire GMs. In the control group, poor repertoire GMs were only seen in 12.5% of the sequences. In the fidgety movement period 20.8% of sequences were assessed as absent fidgety movements, 29.2% as abnormal fidgety movements. The large majority of the videos for the control cases were scored as normal (88.9%), 11.1% had no fidgety movements. According to the Mann-Whitney U test there were significant differences between the ASD and the control groups' optimality scores. The optimality scores were lower in the ASD group. The reduced optimality scores were mainly due to a lack of variable sequences, amplitude and speed of writhing GMs and an altered quality of fidgety and other spontaneous movements in the ASD group. Infants with ASD had more often poor repertoire writhing GMs as well as abnormal or absent fidgety movements than control infants. These data encourage further studies involving a larger number of family videos.
Georgian medical news 04/2008;
-
[show abstract]
[hide abstract]
ABSTRACT: To describe early development of children with regressive autism.
Home movies from the first 18 months of life of three groups of children with early onset autism (EOA), regressive autism (RA) and typical development (TD) were rated through the Grid for Attention in Infants in three age ranges. Different ANOVA and post hoc-tests were conducted on frequencies of behaviours.
Differently from TD, for both RA and EOA non-social attention is higher than social attention across ages. While EOA is characterized by an early deficit in social attention, in RA social attention increases until the first birthday when its decrease proceeds at the same rate as the increase of non-social attention.
We hypothesize that the intense interest towards objects can be the first sign of an atypical development also in RA; this distinguishing feature lead us to believe that regression, based on the assumption of a previous normal development, is only apparent.
Acta Psychiatrica Scandinavica 02/2006; 113(1):68-72. · 4.22 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The objective of the study was to define diagnostic boundaries between Regulatory Disorders (RD) and Multisystem Developmental Disorders (MSDD). Two groups of 15 subjects, between 20 and 36 months of age, diagnosed as RD or MSDD, according to DC: 0–3 (1994) criteria, were compared in relationship, linguistic, and behavioral profiles using specific instruments. The results showed that both RD and MSDD children were impaired on all linguistic measures with a higher significant impairment of MSDD for communicative gestures, spontaneous speech, and verbal comprehension. The Child Behavior Checklist (CBCL) showed significant differences for withdrawn, and somatic problems. Only the MSDD group reached the clinical cutoff score in total problems, internalizing and withdrawn behaviors. A discriminate analysis showed that the number of communicative gestures and the scores on withdrawn and somatic problems correctly predicted in 86% of cases. It was concluded that RD and MSDD children show quantitative and qualitative differences in many of the linguistic, behavioral, and relational dimensions that were explored. These dimensions may facilitate the differential diagnosis of these disorders. ©2003 Michigan Association for Infant Mental Health.
Infant Mental Health Journal 06/2003; 24(4):365 - 377. · 0.61 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Recently it is often very frequent a request of specialist consultation for children with psychic discomfort expressed through somatic complaints and/or behavior disorders. The real meaning of these symptoms in terms of prognosis, is not clear; indeed they can be the first signs of a poor prognosis of developmental disorders or a transient developmental crisis. The objective of this study is the evaluation of a Symptom Checklist as an instrument which allows to point out the somatic complaints and the behavior disorders of Italian children aged less than 48 months and to identify symptoms patterns which label the main neurological and psychiatric diseases in that age.
The Symptom Checklist has been used transversely in a clinical sample of 30 subjects (24 males and 6 females) aged less than 48 months with developmental linguistic disorder, born prematurely or with a developmental pervasive disorder and in a control sample of 37 children (21 males and 16 females).
The results obtained, matching every single group to each other and every single group to the control group, identify symptoms pattern (somatic or behavioral) specific for each clinical condition examined; therefore, the clinical utility of Symptom Checklist in pointing out in infancy psychiatric risk cases for a poor prognosis is confirmed.
Minerva pediatrica 10/1998; 50(9):385-94.
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this paper is to study the psychological and relational aspects in children suffering from specific malformative syndrome and precisely Down s., Sotos s., X-Fragile s. and Williams s. Indeed literature provides much data related to the phenotype, to the organic-biological characteristics, but little or nothing is known about the affective structure, the episodes and to the particular dynamics that emerge in he relation between the parents and the malformed child. A protocol was applied to our sample group (16 subjects). This protocol includes laboratory and instrumental tests (chromosome test, neurometabolic screening, EEG, CT or cranial MRI, cardiac and abdominal ultrasonography, ear and eye test) aspects. This evaluation is carried out through the proposal of standardized situations (psychometric tests) and a use of a freer observational setting. This permits us to understand how the child perceives himself the awareness and the image he has of himself and how able he is to integrate his illness experiences and his way of relating with the environment. The data of our observations are thus used to compile a grill for the structural diagnosis of the personality. Besides, this evaluation is flanked by the observation of the family in order to explore the psychological image that parents have of their child, his character, his good points, his bad points, his similarities, how he relates to them, any educational problems and the emotional reaction that the communication of the diagnosis has raised in them. The videotaped observations are subsequently evaluated through the application of a grill for the study of the mother-child relationship. The results obtained from the psychological research underline a reasonable heterogeneity both of the intellectual level and of the metapsychological profile. Twelve subjects were mentally retarded (5 with mild mental retardation, 7 with moderate mental retardation); the remaining 4 had a normal cognitive development (3 with Sotos s., 1 with Williams s.). Psychological disturbances are present and thus divided: light disturbances (affective immaturity, neurotic-depressive organisation) in 11 subjects. Average disturbances (dysharmonious structure, and borderline personality) in 4 subjects; severe disturbances (psychosis) in 1 subject. Besides, above all in the group of subjects with X-Fragile s. and Down s., the tendency to assume behaviour of a regressive type, also postural, emerges. Among the 4 groups it is frequent to resort to defence mechanisms of hypomaniac type, accompanied by the denial of the patient's "sick parts". Another common characteristic concerns the quality of imaginary life which is shown to be repetitive and stereotype in content. Indeed these children's play activity characterized by a limited capacity of symbolization. Instead, when the symbolic process is more developed, contents concerning a deteriorated and destructive image of the Self emerges. Through the evaluation of family dynamics what is more noticeable is that the parent-malformed child interaction appears to be quite nonstimulating and noninvolving or incoherent, lacking in harmony and empathy towards the child's inner world. Indeed we can notice a lack of both verbal and extraverbal exchange of communication and brief interactive sequences which do not usually take into account the child's proposals and an affective tonality of depressive and nonaffective type. Therefore it may be concluded a certain smoothness in the clinical expression of the syndromes considered, both as far as the cognitive deficit entity and the psychic problems are concerned. Referring to the interactive dynamics between parents and children with dismorphic syndrom it seems that the child's pathology becomes the organizational summit of the above-mentioned relational dynamics among most of the patients examined...
Minerva pediatrica 11/1995; 47(10):385-92.
-
[show abstract]
[hide abstract]
ABSTRACT: The authors describe the natural history and the beginning of pervasive developmental disorders (PDD) by the observation of home movies. The sample is composed of 26 children aged 18 months to 5 or 6 years at the first consultation. The methodology used in the observation of home movies includes: (1) application of the ERC-A-III scale for recognizing the precocious symptoms of autism; (2) analysis of the coming out and coming off of social, emotional and cognitive competences. The authors, starting from the analysis of these data, describe three kinds of onset and courses of PDD: progressive, regressive and fluctuating. The authors present some conclusive considerations on the different age of PDD onset in home movies, in anamnestic reconstruction and in recall for diagnosis.
Psychopathology 32(6):292-300. · 1.82 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Autism spectrum disorders (ASD) are thought to be present right from birth, even if a minority of children displays a normal course during infancy followed by a regression during the second year of life. However, established criteria are not yet available to differentiate these different courses of ASD, and data coming from different sources have not yet been organized into a clear definition. The aim of this study was to elucidate the time of onset, as well as type, frequency and stability of symptoms during the first year of life in ASD. The behavioral summarized evaluation scale, applied to 40 home movies of children later diagnosed as having ASD, showed that most of the subjects (87.5%) display symptoms within the first year of life, when only a small group (12.5%) is completely symptom free. A group of more rated symptoms was found, constituting a typical pattern characterized by being withdrawn, and displaying poor social initiative, hypoactivity, and lack of emotional modulation. The importance of these findings is discussed in relation to early diagnosis and treatment.
Psychopathology 38(1):26-31. · 1.82 Impact Factor
-
S Maestro,
F Muratori,
F Barbieri,
C Casella,
V Cattaneo,
M C Cavallaro,
A Cesari,
A Milone,
L Rizzo,
V Viglione,
D D Stern,
F Palacio-Espasa
[show abstract]
[hide abstract]
ABSTRACT: The main aim of the research is to study the early behavioral development in autistic children through home movies.
fifteen home movies, regarding the first 2 years of life of autistic children are compared with the home movies of 15 normal children. The films of the two groups were mixed and rated by blind ratings with the Grid for the Assessment of Normal Behavior in Infants and Toddlers. The grid is composed of 17 items grouped into three developmental areas: social competence, intersubjectivity and symbolic activity. For every area, we have identified specific children's behaviors.
Significant differences between the two groups are found both in the range of age 0-6 for intersubjectivity, and in the ranges of age 6-12 and 18-24 for symbolic activity.
The authors pose some hypotheses about an early-appearing impairment of intersubjectivity, the ability to represent other's state of mind, in subjects with autistic disorder.
Psychopathology 34(3):147-52. · 1.82 Impact Factor
