Comorbid psychopathology in infants and toddlers with autism and pervasive developmental disorders-not otherwise specified (PDD-NOS)

doi:10.1016/j.rasd.2009.10.001

Research in Autism Spectrum Disorders

Volume 4, Issue 2, April–June 2010, Pages 300-304

https://doi.org/10.1016/j.rasd.2009.10.001 Get rights and content

Abstract

The purpose of this study was to investigate symptoms of comorbid disorders in infants and toddlers with autism spectrum disorders (ASDs). Research is scant on symptoms of co-occurring mental health conditions in this very young population. Method: Three hundred and twenty four participants were included in this study. Participants were classified into one of three groups: Autistic Disorder, Pervasive Developmental Disorder-Not Otherwise Specified, and control. A Multivariate Analysis of Variance (MANOVA) was utilized to assess group differences on the six subscales of the Baby and Infant Screen for Children with aUtIsm Traits-Part 2 (BISCUIT-Part 2). Results: The MANOVA revealed a significant main effect for group. Follow-up analyses showed that all subscales contributed to the significant main effect of the MANOVA. Discussion: The results of the analyses in this study are consistent with the current literature on older children and adults with ASDs. Implications of early identification of comorbid disorders are discussed. Further research on the mental health of infants and toddler with autism spectrum disorders (ASDs) is warranted.

Section snippets

Participants

The participants for this study included infants and toddlers enrolled in an early intervention program funded by the State of Louisiana. EarlySteps is Louisiana's Early Intervention System under the Individuals with Disabilities Education Act, Part C, which provides services to infants and toddlers and their families from birth to 36 months. Children qualify for these services if they have a developmental delay or a medical condition likely to result in a developmental delay. Participants in

Results

A Multivariate Analysis of Variance (MANOVA) was utilized to assess group (i.e., AD, PDD-NOS, control) differences on the five subscales of the BISCUIT-Part 2. Prior to this analysis, the assumptions of MANOVA were examined and corrected. Research regarding the correlations between dependent variables used in a MANOVA is inconsistent. That is, some suggest that highly negatively or moderately correlated dependent variables increase power for the MANOVA (Tabachnick and Fidell, 2007), whereas,

Discussion

The purpose of his study was to examine and compare scores on a measure of comorbid psychopathology in very young children. Research on children with ASDs consistently finds that this particular population exhibits higher rates of co-occurring disorders (Schreck et al., 2004, Kim et al., 2000, Gillberg and Billstedt, 2000). Much less is known about symptoms of comorbid psychopathology in very young children, specifically infants and toddlers. The dearth of studies on this topic may be due in

References (38)

E. Ben Itzchak et al.
Cognitive, behavior and intervention outcome in young children with autism
Research in Developmental Disabilities
(2008)
J.E. Dawson et al.
An analysis of maladaptive behaviors in persons with autism, PDD-NOS, and mental retardation
Research in Developmental Disabilities
(1998)
J. Kim et al.
The prevalence of anxiety and mood problems among children with autism and Asperger Syndrome
Autism
(2000)
C. Lord et al.
Early diagnosis of children with autism spectrum disorders
Clinical Neuroscience Research
(2006)
J.L. Matson
Determining treatment outcome in early intervention programs for autism spectrum disorders: A critical analysis of measurement issues in learning based interventions
Research in Developmental Disabilities
(2007)
J.L. Matson et al.
Characteristics of autism as assessed by the diagnostic assessment for the severely handicapped-II (dash-II)
Research in Developmental Disabilities
(1996)
J.L. Matson et al.
Reliability of the assessment of dual diagnosis (add)
Research in Developmental Disabilities
(1998)
J.L. Matson et al.
The relationship of self-injurious behavior and other maladaptive behaviors among individuals with severe and profound intellectual disability
Research in Developmental Disabilities
(2008)
J.L. Matson et al.
Comorbid psychopathology with autism spectrum disorder in children: An overview
Research in Developmental Disabilities
(2007)
J.L. Matson et al.
Characteristics of depression as assessed by the diagnostic assessment for the severely handicapped-II
Research in Developmental Disabilities
(1999)

J.L. Matson et al.

Current status of intensive behavioral interventions for young children with autism and PDD-NOS

Autism Spectrum Disorder

(2008)

J.L. Matson et al.

Reliability and item content of the baby and infant screen for children with autism traits (BISCUIT): Parts 1–3

Autism Spectrum Disorder

(2009)

T.R. Paclawskyj et al.

A comparison of the diagnostic assessment for the severely handicapped-II (dash-II) and the aberrant behavior checklist (ABC)

Research in Developmental Disabilities

(1997)

J.E. Ringdahl et al.

Assessment and treatment of aggressive behavior without a clear social function

Research in Developmental Disabilities

(2008)

American Psychiatric Association [APA]

Diagnostic and statistical manual of mental disorders-text revision

(2000)

T. Attwood

Asperger's Syndrome

(1998)

C. Barthélémy et al.

Sensitivity and specificity of the behavioral summarized evaluation (BSE) for the assessment of autistic behaviors

Journal of Autism and Developmental Disorders

(1992)

D. Evans et al.

The fears, phobias and anxieties of children with autism spectrum disorders and Down syndrome: Comparisons with developmentally and chronologically age matched children

Child Psychiatry and Human Development

(2005)

L.C. Eaves et al.

The very early identification of autism: Outcome to age 4 1/2-5

Journal of Autism and Developmental Disorders

(2004)

Cited by (66)

Measurement invariance of the child behavior checklist in children with autism spectrum disorder with and without intellectual disability: Follow-up study
2019, Research in Autism Spectrum Disorders
Children with autism spectrum disorder (ASD) have high rates of co-occurring emotional and behavioral problems. The Child Behavior Checklist (CBCL) has been used to assess emotional and behavioral functioning in many large-scale studies of children with ASD. However, the previously established factor model may account for symptom patterns differently in children with concurrent intellectual disability (ID).
In a sample of children with ASD, a multi-group nested confirmatory factor analysis was used to compare participant groups with and without concurrent ID on each of the subscales of the CBCL.
In almost all of the subscales, children with ASD and concurrent ID exhibit different baseline levels, measurement error, and overall predictive ability on the behavioral and emotional problems of the CBCL than children with ASD alone. In younger children with ASD, configural invariance was present in Emotional Reactivity, Anxious/Depressed, and Somatic Complaints, metric invariance was present in Sleep Problems, residual invariance was present in Withdrawn Behavior, and structural invariance was present in Attention Problems and Aggressive Behavior. In older children with ASD, configural invariance was present in Anxious/Depressed, Somatic Complaints, Social Problems, Thought Problems, Attention Problems, and Rule-Breaking; whereas, metric invariance was present in Withdrawn/Depressed and Aggressive Behavior.
In conclusion, when dealing with intellectually heterogeneous ASD samples, the item-level data of the CBCL should be used, rather than broad subscale-level data. These findings underscore a continued need for development and validation of measures that are appropriate for use in individuals with ASD across ages and intellectual functioning.
Comorbid Behavior Problems Among Youth With Intellectual and Developmental Disabilities: A Developmental Focus
2018, International Review of Research in Developmental Disabilities
It has been well documented that individuals with autism spectrum disorder or intellectual disabilities demonstrate comorbid behavior problems, or behaviors that are not specified by the criteria for the diagnosis. Co-occurring behavior problems can substantially interfere with the child's educational and social functioning, lead to poor long-term child outcomes, negatively impact family outcomes, and create additional challenges for treatment and intervention. However, what is less clear is how the impact of behavior problems evolves across crucial stages of development, with differential effects at different ages. A better understanding of the trajectory of co-occurring behavior problems is important for improving outcomes across domains, including social, academic, and mental health. This chapter begins with a brief overview of autism spectrum disorder and intellectual disability, including the expression of comorbidity in these populations, and provides a review of the literature pertaining to the developmental course of behavior problems and their collateral effects on the school and family environment. We conclude with a discussion of future directions for research on behavior problems and intervention efforts for individuals with intellectual and developmental disabilities.
Autism spectrum disorder and attention-deficit/hyperactivity disorder in early childhood: A review of unique and shared characteristics and developmental antecedents
2016, Neuroscience and Biobehavioral Reviews
Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have overlapping characteristics and etiological factors, but to which extent this applies to infant- and preschool age is less well understood. Comparing the pathways to ASD and ADHD from the earliest possible stages is crucial for understanding how phenotypic overlap emerges and develops. Ultimately, these insights may guide preventative and therapeutic interventions. Here, we review the literature on the core symptoms, temperament and executive function in ASD and ADHD from infancy through preschool age, and draw several conclusions: (1) the co-occurrence of ASD and ADHD increases with age, severity of symptoms and lower IQ, (2) attention problems form a linking pin between early ASD and ADHD, but the behavioral, cognitive and sensory correlates of these attention problems partly diverge between the two conditions, (3) ASD and ADHD share high levels of negative affect, although the underlying motivational and behavioral tendencies seem to differ, and (4) ASD and ADHD share difficulties with control and shifting, but partly opposite behaviors seem to be involved.
The relationship between comorbid psychopathologies, autism, and social skill deficits in young children
2015, Research in Autism Spectrum Disorders
Social skills are important for both social development and integration. However, few studies have looked at these behaviors in the context of severity of autism spectrum disorder (ASD) symptoms and comorbid psychopathology in young children. Three hundred twenty eight infants and toddlers between 18 and 36 months of age diagnosed with ASD were studied. More severe symptoms of ASD and various forms of emotional distress such as tantrums and inattention/impulsivity were associated with greater difficulties in social behavior.
Why pharmacotherapy is overused among persons with Autism Spectrum Disorders
2015, Research in Autism Spectrum Disorders
Autism Spectrum Disorder (ASD) is a relatively common disorder with lifelong and lasting impairments. As a result, professionals are developing and using a host of intervention strategies. In addition to applied behavior analysis, pharmacotherapy has played a critical role in the advancements of treatment. The use of pharmacological interventions has played a central and important role in recent treatment innovations. Despite the many positive aspects of these drugs, they have often been overused. The present paper reviews many of the reasons for this phenomenon.
The curious selection process of treatments for Autism Spectrum Disorders
2015, Research in Autism Spectrum Disorders
Treatments for Autism Spectrum Disorder (ASD) vary widely. The disorder is now considered treatable, but some interventions have extensive empirical support, while other interventions have none. Despite these stark differences in the evidence base for interventions, and efforts to educate the public, little correlation exists between what treatments work and what treatments parents choose. This review covers treatments, what people choose, and possible reasons choices are made, plus what factors may influence these choices. Data of this sort are important for clinicians and researchers, since multiple issues dictate treatment selection.

View all citing articles on Scopus

View full text

Comorbid psychopathology in infants and toddlers with autism and pervasive developmental disorders-not otherwise specified (PDD-NOS)

Abstract

Section snippets

Participants

Results

Discussion

Research in Developmental Disabilities

Research in Developmental Disabilities

Autism

Clinical Neuroscience Research

Research in Developmental Disabilities

Research in Developmental Disabilities

Research in Developmental Disabilities

Research in Developmental Disabilities

Research in Developmental Disabilities

Research in Developmental Disabilities

Autism Spectrum Disorder

Autism Spectrum Disorder

Research in Developmental Disabilities

Research in Developmental Disabilities

Diagnostic and statistical manual of mental disorders-text revision

Asperger's Syndrome

Sensitivity and specificity of the behavioral summarized evaluation (BSE) for the assessment of autistic behaviors

Journal of Autism and Developmental Disorders

The fears, phobias and anxieties of children with autism spectrum disorders and Down syndrome: Comparisons with developmentally and chronologically age matched children

Child Psychiatry and Human Development

The very early identification of autism: Outcome to age 4 1/2-5

Journal of Autism and Developmental Disorders