IACAPAP 2012 – 20th World congress / Neuropsychiatrie de l’enfance et de l’adolescence 60S (2012) S197–S253 Assessment of Autism Spectrum Disorders (ASD) in children is complex because of the heterogeneous nature of this population and the high incidence of comorbidity. There is also limited information available about the utility of assessment tools in the assessment of ASDs in high-functioning children. A consistent process for this assessment was developed and trialled in a tertiary level children’s mental health service across three outpatient teams. In addition to standard assessment interviews and cognitive and language assessment, the assessment battery included the Autism Diagnostic Observation Schedule (ADOS), the Social Communication Questionnaire (SCQ), the Childhood Autism Rating Scale (CARS). A total of 104 children completed the standardised multi-disciplinary assessment. The sample included children aged from 5 to 15 years (mean = 10.5 years) of which 81% were male. The value of these assessment tools is explored in order to determine whether they contribute meaningful information to the process of diagnosis. http://dx.doi.org/10.1016/j.neurenf.2012.04.497
Considerations on the relationship between autism spectrum disorder and major depression in adolescents T. Abe Psychiatry, Jichi Medical University, Shimotsuke, Japan Adolescents with autism spectrum disorder (ASD), particularly-high functioning autistic youths, often present with depression due to maladaptation to school life caused by their specific cognitive behavioral patterns. These depressive symptoms are so diverse that the individual may be diagnosed with adjustment disorder, dysthymia, major depression or other pathologies based on the DSM-IV. The two cases of ASD with major depression reported here show that some traits of ASD have considerable influence over the onset and clinical picture of depression. Case 1 was characterized by psychomotor retardation with markedly diminished interest in all activities, but showed no sleep disturbance. Case 2 was characterized by psychomotor agitation with panic attacks and suicidal ideation. Depressive symptoms in both cases could be considered a kind of vital emergency reaction, and were changeable depending on situation in which each patient was placed. In conclusion, few cases of ASD show depression with melancholic features. http://dx.doi.org/10.1016/j.neurenf.2012.04.498
and free GSH, may be a predictive biomarker of which children will demonstrate positive clinical response to MB12. http://dx.doi.org/10.1016/j.neurenf.2012.04.499 Tu-P-2122
Obsessive compulsive symptoms in children with autistic spectrum disorder
L. Low ∗ , M. Sung , Y.P. Ooi , S.J. Weng , J. Seah Department Of Child And Adolescent Psychiatry, Institute of Mental Health, Singapore ∗ Corresponding author. Objective.– Children with Autistic Spectrum Disorder (ASD) may experience overlapping symptoms such as obsessional interests and behaviours as children with Obsessive Compulsive Disorder (OCD). Establishing the presence of these symptoms in children with ASD can be useful as obsessions and compulsions are amenable to treatment, which may result in improved functioning in children. Our aim is to evaluate the presence of OC symptoms in children diagnosed with ASD and to determine the level of distress associated with these symptoms. Methods.– A prospective descriptive study was carried out on 18 participants diagnosed with ASD to determine the presence and level of distress associated with OC symptoms. 18 participants between 7–18 years of age (mean = 11.39, SD = 3.81) diagnosed with ASD were interviewed by a clinician using the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Results.– The total CY-BOCS scores obtained by the participants in the study ranged from 0 to 15. Out of the 18 participants, 11 had OC symptoms in the subclinical range (0–7) whilst seven participants had mild (8–15) OC symptoms. In terms of the level of distress associated with compulsive symptoms, one participant reported severe distress, three reported moderate distress whilst two reported mild distress. With respect to obsessive symptoms, two participants reported mild distress. Discussion.– This study aims to document the presence of OC symptoms in our sample of children with ASD. Knowledge of which will lay the groundwork in developing treatments, which target OC symptoms in ASD and aid in our understanding of how such treatment may benefit these individuals with overlapping profiles. http://dx.doi.org/10.1016/j.neurenf.2012.04.500 Tu-P-2123
Double-blind placebo controlled trial of methyl B12 on behavioral and metabolic measures in children with autism F. Widjaja a,∗ , S.J. James b , R.L. Hendren a a Psychiatry, University of California, San Francisco, San Francisco, USA b Pediatrics, University of Arkansas, Little Rock, USA ∗ Corresponding author. Nutritional supplementation through subcutaneous injections of methyl B12 is a current treatment for children with autism with reports of clinical improvements and few side effects. However, this remains an understudied biomedical treatment. Children with autism have been shown to exhibit markers of oxidative stress, which may be improved by methyl B12. Alterations in fetal nutrition and metabolism, including deficiency from a variety of essential methyl donor groups such as methyl B12, may epigenetically cause developmental adaptations that permanently change the structure, physiology, and metabolism of offspring and lead to a predisposition of several diseases later in life. Hypothesis.– Methylcobalamin injections will improve measures of executive function, speech and socialization and will be associated with metabolic improvement in redox metabolism. Preliminary results.– Forty subjects enrolled for an eight-week, DBPC trial in children ages 3–7 with autism. A subgroup of responders was identified (31%) as subjects that showed improvement of > 2 points on the CGI and two other behavioral measures. MB12 treatment resulted in a .59-point greater average improvement on the CGI and a 9.4-point greater average improvement in ABC. Initial levels of pre-treatment glutathione measurements, particularly total GSH
Challenges encountered while raising a child with autism in Bangladesh R. Hoque ∗ , M.M. Karim Department Of Occupational Therapy, CRP, Savar, Dhaka, Bangladesh ∗ Corresponding author.
Background.– Autism is a Pervasive Developmental Disorder (PDD) which affects a Childs’ family system and society. Family members have to face difficulties to raise a child with autism. Aim of the study.– To explore challenges that encountered while raising a child with autism in Bangladesh. Methodology.– The study was conducted using phenomenological method. Twenty caregivers of children with autism were selected as the study participants by purposive sampling. Data were generated by using data triangulation through five individual interviews, three focus-group discussions and observation. Data were analyzed using content analysis under category, code and preparing theme for result. Results.– Challenges of raising children with autism are:face difficulty to understand the need, feelings of children, their level of development, to recognize learning need of children, difficulty engaging children in Activities of Daily Living (ADL) and lack of social communication. Conclusion.– The finding of the study provides important considerations for professionals and caregivers to know the challenges in specific ways and discover their solutions. http://dx.doi.org/10.1016/j.neurenf.2012.04.501