Pervasive Developmental Disorder- not Otherwise Specified: Specifying and Differentiating retained all components with eigenvalue(a measure of explained variance) greater than unity. Ten factors had eigenvalues greater than 1.0, which is a common criterion for a factor to be useful. When ten factors were requested, Kaiser-Meyer-Olkin(KMO)measure was adequate(66), and Bartlett's Test of Spherity was significant (p<.001). These measures mean that the variables are correlated highly enough to provide a reasonable basis for factor analysis. We considered all variables with factor loadings 0.3 or larger in the appropriate factor matrices to define the underlying factor and we took these variables as a cluster of variables for the factor. The two rotation procedures produced similar results. When there were differences, we took the Promax solution as the preferred one. After rotation, ten factors accounted for 66.3% of the variance ■ PUU-NOS ADHD il Factor 1 Factor 2 Factor 3 Factor 4 Factor 5 Factor 7 Factor 8 Factor 1 includes"lack of eye contact,"stereotypies","inappropriate laughing","frequent startles highly interestedness in TV", and" tactile oversensitiveness Factor 2 includes" poor social interaction","language retardation, and"not responsive Factor 3 includes"inattentiveness","hyperactivity, and"impatient, impulsiveness Factor 4 includes iveness"and"conduct problems Factor 5 includes"confusing pronouns","echolalia", and"articulation/ prosody problems Factor 7 includes"fastidiousness, choosiness"and"obsessions Factor 8 includes"poor appetite,stubbornness", and"persistence with sameness Fig. 2. The significantly discriminative factors of the diagnostic groups We found significant differences in the toal number of symptoms between three diagnostic groups in the factors 1(p<001),2(p<001)3(P<001),4(p=004),5(P<001),7(p=026),and 8(p=.006). The scores in the factors 1, 2, 3, and 8 were significantly higher in the autism group compared to the PDD-NOS group. The scores in the factors 1, 2, 5, and 7 were significantly higher in the PDD-NOS group compared to the ADhd group. Inversely, the scores in the factors 3, 4, and 8 were significantly higher in the adhd group compared to he PDD-NOS group(Figure 2)
Pervasive Developmental Disorder- not Otherwise Specified: Specifying and Differentiating 23 retained all components with eigenvalue (a measure of explained variance) greater than unity. Ten factors had eigenvalues greater than 1.0, which is a common criterion for a factor to be useful. When ten factors were requested, Kaiser-Meyer-OIkin (KMO) measure was adequate (.66), and Bartlett’s Test of Spherity was significant (p<.001). These measures mean that the variables are correlated highly enough to provide a reasonable basis for factor analysis. We considered all variables with factor loadings 0.3 or larger in the appropriate factor matrices to define the underlying factor and we took these variables as a cluster of variables for the factor. The two rotation procedures produced similar results. When there were differences, we took the Promax solution as the preferred one. After rotation, ten factors accounted for 66.3% of the variance. Factor 1 includes “lack of eye contact”, “stereotypies”, “inappropriate laughing”, “frequent startles”, “highly interestedness in TV”, and “tactile oversensitiveness”; Factor 2 includes “poor social interaction”, “language retardation”, and “not responsive” Factor 3 includes “inattentiveness”, “hyperactivity”, and “impatiente, impulsiveness” Factor 4 includes “aggressiveness” and “conduct problems” Factor 5 includes “confusing pronouns”, “echolalia”, and “articulation/ prosody problems” Factor 7 includes “fastidiousness, choosiness” and “obsessions” Factor 8 includes “poor appetite”, “stubbornness”, and “persistence with sameness” Fig. 2. The significantly discriminative factors of the diagnostic groups. We found significant differences in the toal number of symptoms between three diagnostic groups in the factors 1 (p<.001), 2 (p<.001), 3 (p<.001), 4 (p=.004), 5 (p<.001), 7 (p=.026), and 8 (p=.006). The scores in the factors 1, 2, 3, and 8 were significantly higher in the autism group compared to the PDD-NOS group. The scores in the factors 1, 2, 5, and 7 were significantly higher in the PDD-NOS group compared to the ADHD group. Inversely, the scores in the factors 3, 4, and 8 were significantly higher in the ADHD group compared to the PDD-NOS group (Figure 2)
Autism Spectrum Disorders: The Role of Genetics in Diagnosis and Treatment Based on the assumption that the items were predicted to index three constructs: sympton related to autism, ADHD, and PDD-NOS, in a further analysis three factors were requested (Karabekiroglu Akbas, In press ). The first factor seemed to index core autism spectrum, the second factor, disruptive behaviors spectrum, and the third factor seemed to index symptoms to be interpreted as anxiety spectrum. Four in twenty-seven items do not seem to load with any of the factors. When the total number of the symptoms in each factor were compared between the diagnostic groups, the core autism spectrum and the disruptive behavior spectrum factors revealed significant differences between the groups(p<.001). Post-hoc analysis showed that in the core autism spectrun factor, the autistic group had significantly more symptoms than the PDD-NOS group (4.87 vs. 2.14)(p<.001), and the PDD-NOS group had significantly more symptoms than the adhd group(2. 14 vs 0. 81)(p<.001). On the other hand, on the disruptive behavior spectrum factor, both the ADHD (3.62 vS. 2. 19)(p<.001) and the autistic groups(4.55 VS. 2. 19)(p<.001) had significantly more symptoms than the PDD-NOS group. The anxiety spectrum factor did not reveal a significant difference between 4. Discussion Because the diagnostic agreement for PDD-NOS was generally considered to be weak Tanguay 2004, Walker et al. 2004), and differentiation of PDD-NOS from the non-PDD disorders, such as ADHD was not well-defined, we conducted a factor analysis including the data from all three diagnosis groups(Autism, PDD-NOS, and ADHD)(Karabekiroglu akbas, in press). A factor analysis revealed three symptom clusters, core autistic spectrum, irruptive behavior spectrum, and anxiety spectrum. As would be expected, the children with autism had higher rates of symptoms in the autistic spectrum factor and the children with ADHD had higher rates of symptoms in the disruptive behavior spectrum factor. The PDD- NOS group had lower rates of symptoms on both factors In a recent study( Kamp-Becker et al. 2009), the dimensional structure of higher functioning autism phenotype was investigated by factor analysis. The goal of this study was to identify the degree to which early symptoms of autism(measured using the ADI-R)could be predictive of the current symptoms of autism as identified using the ADOS, the adaptive behavior scales, IQ scores and theory of mind scores. The authors reported that the social interaction and communication domains were closely related to one factor namely: Social communication. An additional factor implies anxious and compulsive behavior which is associated with current social communication functioning. Another study compared the behavioral symptomatology in 26 children and adolescents with autism and 25 children and dolescents with PDD-NOS(Pearson et al., 2006). Relative to individuals with PDD-NOS, those with autism had more symptoms of depression, social withdrawal, atypical behavior and immature social skills, and fewer family problems. These differences remained even when group differences in intellectual ability were controlled statistically. No group differences emerged in somatization, anxiety, or hyperactivity. Their findings suggested that, although both groups demonstrated considerable evidence of behavioral and emotional problems, those with autism were at particularly high risk for co-morbid behavioral and emotional disabilities(Pearson et al., 2006) In a recent study(Mandy et al., 2011)authors aimed, first, to improve the reliability and replicability of PDD-NOS by operationalizing its DSM-IV-TR description and, second, to test its validity through comparison with autistic disorder(AD) and Aspergers disorder(AsD)
24 Autism Spectrum Disorders: The Role of Genetics in Diagnosis and Treatment Based on the assumption that the items were predicted to index three constructs: symptoms related to autism, ADHD, and PDD-NOS, in a further analysis three factors were requested (Karabekiroglu & Akbas, In press). The first factor seemed to index core autism spectrum, the second factor, disruptive behaviors spectrum, and the third factor seemed to index symptoms to be interpreted as anxiety spectrum. Four in twenty-seven items do not seem to load with any of the factors. When the total number of the symptoms in each factor were compared between the diagnostic groups, the core autism spectrum and the disruptive behavior spectrum factors revealed significant differences between the groups (p<.001). Post-hoc analysis showed that in the core autism spectrum factor, the autistic group had significantly more symptoms than the PDD-NOS group (4.87 vs. 2.14) (p<.001), and the PDD-NOS group had significantly more symptoms than the ADHD group (2.14 vs. 0.81) (p<.001). On the other hand, on the disruptive behavior spectrum factor, both the ADHD (3.62 vs. 2.19) (p<.001) and the autistic groups (4.55 vs. 2.19) (p<.001) had significantly more symptoms than the PDD-NOS group. The anxiety spectrum factor did not reveal a significant difference between diagnostic groups. 4. Discussion Because the diagnostic agreement for PDD-NOS was generally considered to be weak (Tanguay 2004, Walker et al. 2004), and differentiation of PDD-NOS from the non-PDD disorders, such as ADHD was not well-defined, we conducted a factor analysis including the data from all three diagnosis groups (Autism, PDD-NOS, and ADHD) (Karabekiroglu & akbas, in press). A factor analysis revealed three symptom clusters, core autistic spectrum, disruptive behavior spectrum, and anxiety spectrum. As would be expected, the children with autism had higher rates of symptoms in the autistic spectrum factor and the children with ADHD had higher rates of symptoms in the disruptive behavior spectrum factor. The PDDNOS group had lower rates of symptoms on both factors. In a recent study (Kamp-Becker et al., 2009), the dimensional structure of higher functioning autism phenotype was investigated by factor analysis. The goal of this study was to identify the degree to which early symptoms of autism (measured using the ADI-R) could be predictive of the current symptoms of autism as identified using the ADOS, the adaptive behavior scales, IQ scores and theory of mind scores. The authors reported that the social interaction and communication domains were closely related to one factor namely: Social communication. An additional factor implies anxious and compulsive behavior which is associated with current social communication functioning. Another study compared the behavioral symptomatology in 26 children and adolescents with autism and 25 children and adolescents with PDD-NOS (Pearson et al., 2006). Relative to individuals with PDD-NOS, those with autism had more symptoms of depression, social withdrawal, atypical behavior, and immature social skills, and fewer family problems. These differences remained even when group differences in intellectual ability were controlled statistically. No group differences emerged in somatization, anxiety, or hyperactivity. Their findings suggested that, although both groups demonstrated considerable evidence of behavioral and emotional problems, those with autism were at particularly high risk for co-morbid behavioral and emotional disabilities (Pearson et al., 2006). In a recent study (Mandy et al., 2011) authors aimed, first, to improve the reliability and replicability of PDD-NOS by operationalizing its DSM-IV-TR description and, second, to test its validity through comparison with autistic disorder (AD) and Asperger’s disorder (AsD)
Pervasive Developmental Disorder- not Otherwise Specified: Specifying and Differentiating (n: 66)1, groups were compared on independent measures of core PDD symptomatoloo In a sample of 256 young people(mean age: 9.1 years)[AD(n: 97), AsD (n: 93)and PDD-N associated autistic features, and intelligence. Contrary to the assumption that PDD-NOS heterogeneous, almost all(97%)of those with PDD-NOS had one distinct symptom pattern, namely impairments in social reciprocity and communication, without significant repetitive and stereotyped behaviors(RSB). Compared to AD and AsD, they had comparably severe but more circumscribed social communication difficulties, with fewer non-social features of autism, such as sensory, feeding and visuo-spatial problems. These individuals appear to have a distinct variant of autism that does not merely sit at the less severe end of the same continuum of symptoms The symptoms of ASD may change with development(Luyster et al., 2005). PDD-NOS has been assumed significantly less stable as a diagnosis(Lord et al. 2006). In a study(Kleinman et al. 2008), 77 children received a diagnostic and developmental evaluation between 16 and 5 months and also between 42 and 82 months. Diagnoses based on clinical judgment, Childhood Autism Rating Scale, and the Autism Diagnostic Observation Schedule were stable over time. Diagnoses made using the Autism Diagnostic Interview were slightly less stable. According to clinical judgment, 15 children(19%)moved off the autism spectrum by the second evaluation; none moved onto the spectrum. Results indicate diagnostic stability at acceptable levels for diagnoses made at age 2. Nevertheless, diagnoses of autism and PDD-NOS by experienced clinicians on the basis of multiple measures were valid and reliable over time(Lord et al., 2006). If a child is given an ASd diagnosis(either autism or PDD-NOS) at age 2 years, it is highly likely to apply at age 9, although there may be some shifting within the range of Asd diagnostic categories Lord et al. 2006). Generally, it appears that the overall picture of development for autism and PDD-NOS is similar, with most children experiencing continued impairment. Based on these two studies, there does ot appear to be evidence for qualitatively discrete groups(.e, autism versus PDD-NOS), but differences appear to be quantitative( Lord et al., 2006; Turner, et al. 2006) A recent meta-analysis(Rondeau et al. 2010) conducted on the eight longitudinal studies on PDD-NOS that have been published from 1996 to 2009 showed that PDD-NOS diagnosis was less stable than autistic disorder diagnosis. When established before 36 months, the overall stability rate was 35%at 3-year follow-up. Consistent with the previous literature on the reliability of the PDD-NOS diagnosis in young children, our metaanalysis did not support the discriminant and predictive validity of this category. Thus, from a clinical standpoint, children whose PDD-NOS diagnosis was established before 36 months should be re-assessed at a later age(Rondeau et al, 2010). Similar to previous reports(Allen et al., 2001, deBruin et al., 2006, Matson, et al, 2007, Szatmari et al. 2002), in our study(Karabekiroglu Akbas, in press)mental retardation was significantly more prevalent in the autism than in the PDD-NOS or ADHD groups. Several investigators suggested that exploring the presence of mental retardation may be more useful in terms of planning treatment and predicting outcome than a classification based on symptom number alone( Szatmari et al., 2002). However, IQ may be a poor measure of level of functioning, based as it is on performance in a highly artificial setting( Szatmari et al. 2002). In a study(Scheirs Timmers, 2009)an attempt was made to distinguish among the three groups(ADHD, PDD-NOS, and ADHD plus PDD-NOS)on the basis of intelligence (WISC-IIl)profiles. It was found that the PDD-NOs group had higher verbal and performance lQs, as well as higher WISC-IlI index scores than the ADHd group. Subtests
Pervasive Developmental Disorder- not Otherwise Specified: Specifying and Differentiating 25 In a sample of 256 young people (mean age: 9.1 years) [AD (n:97), AsD (n:93) and PDD-NOS (n:66)], groups were compared on independent measures of core PDD symptomatology, associated autistic features, and intelligence. Contrary to the assumption that PDD-NOS is heterogeneous, almost all (97%) of those with PDD-NOS had one distinct symptom pattern, namely impairments in social reciprocity and communication, without significant repetitive and stereotyped behaviors (RSB). Compared to AD and AsD, they had comparably severe but more circumscribed social communication difficulties, with fewer non-social features of autism, such as sensory, feeding and visuo-spatial problems. These individuals appear to have a distinct variant of autism that does not merely sit at the less severe end of the same continuum of symptoms. The symptoms of ASD may change with development (Luyster et al., 2005). PDD-NOS has been assumed significantly less stable as a diagnosis (Lord et al., 2006). In a study (Kleinman et al., 2008), 77 children received a diagnostic and developmental evaluation between 16 and 35 months and also between 42 and 82 months. Diagnoses based on clinical judgment, Childhood Autism Rating Scale, and the Autism Diagnostic Observation Schedule were stable over time. Diagnoses made using the Autism Diagnostic Interview were slightly less stable. According to clinical judgment, 15 children (19%) moved off the autism spectrum by the second evaluation; none moved onto the spectrum. Results indicate diagnostic stability at acceptable levels for diagnoses made at age 2. Nevertheless, diagnoses of autism and PDD-NOS by experienced clinicians on the basis of multiple measures were valid and reliable over time (Lord et al., 2006). If a child is given an ASD diagnosis (either autism or PDD-NOS) at age 2 years, it is highly likely to apply at age 9, although there may be some shifting within the range of ASD diagnostic categories (Lord et al., 2006). Generally, it appears that the overall picture of development for autism and PDD-NOS is similar, with most children experiencing continued impairment. Based on these two studies, there does not appear to be evidence for qualitatively discrete groups (i.e., autism versus PDD-NOS), but differences appear to be quantitative (Lord et al., 2006; Turner, et al., 2006). A recent meta-analysis (Rondeau et al., 2010) conducted on the eight longitudinal studies on PDD-NOS that have been published from 1996 to 2009 showed that PDD-NOS diagnosis was less stable than autistic disorder diagnosis. When established before 36 months, the overall stability rate was 35% at 3-year follow-up. Consistent with the previous literature on the reliability of the PDD-NOS diagnosis in young children, our metaanalysis did not support the discriminant and predictive validity of this category. Thus, from a clinical standpoint, children whose PDD-NOS diagnosis was established before 36 months should be re-assessed at a later age (Rondeau et al., 2010). Similar to previous reports (Allen et al., 2001, deBruin et al., 2006, Matson, et al., 2007, Szatmari et al. 2002), in our study (Karabekiroglu & Akbas, in press) mental retardation was significantly more prevalent in the autism than in the PDD-NOS or ADHD groups. Several investigators suggested that exploring the presence of mental retardation may be more useful in terms of planning treatment and predicting outcome than a classification based on symptom number alone (Szatmari et al., 2002). However, IQ may be a poor measure of level of functioning, based as it is on performance in a highly artificial setting (Szatmari et al. 2002). In a study (Scheirs & Timmers, 2009) an attempt was made to distinguish among the three groups (ADHD, PDD-NOS, and ADHD plus PDD-NOS) on the basis of intelligence (WISC-III) profiles. It was found that the PDD-NOS group had higher verbal and performance IQ’s, as well as higher WISC-III index scores than the ADHD group. Subtests
Autism Spectrum Disorders: The Role of Genetics in Diagnosis and Treatment Block Design and Mazes discriminated best. It was concluded that based on intellige scores, only PDD-NOS and ADHD emerged as distinct categories, whereas the combine diagnosis did not. Allen et al. (2001 )compared 18 preschool children with PDD-NOS to 176 children with autistic disorder and 311 non-autistic children with developmental language disorders(Dld)(N- 201)or low IQ(N=110). The children with PDD-NOS did not differ significantly from either the children with autism or the children with DLD in verbal and adaptive skills. They suggested that the similarity of PDD-NOS children to autistic children in maladaptive behaviors and an intermediate position between autistic and dLd groups on virtually all measures helped to explain the difficulty clinicians encounter in classifying hildren with PDD-NOS(Allen et al., 2001) Rates of comorbid psychiatric conditions in children with PDD-NOS are hardly available, although these conditions are often considered as more responsive to treatment than the core symptoms of PDD-NOS(de Bruin et al, 2007). In our sample( Karabekiroglu Akbas in press),53.2% of the children with PDD-NOS had at least one co-morbid psychiatric disorder, including disruptive behavior disorders(40.4%), and anxiety disorders(18.0%) With respect to the PDD-NOS group, the adhd group had significantly higher rates of co- morbid disruptive behavior disorders, learning disabilities, tic disorders, elimination disorders, and social anxiety disorder. On the other hand, the PDD-NOs group had significantly higher rates of co-morbid obsessive compulsive disorder with respect to the ADHD group. In a previous study, De Burin et al. (2007)explored the comorbidity in ninety four children with PDD-NOS, aged 6-12 years. At least one co-morbid psychiatric disorder was present in 80.9% of the children; 61.7% had a co-morbid disruptive behavior disorder, and 55.3% fulfilled criteria of an anxiety disorder. Compared to those without co-morbid psychiatric disorders, children with a co-morbid disorder had more deficits in social 5. Conclusion The overall results suggest that children with PDD-NOS have a high number of common features with patients having autism and ADHD. The symptoms of all three diagnostic groups appeared to form three clusters, "autistic spectrum, ""ADHD spectrum, "an anxiety spectrum. Many features including language and motor developmen presenting"and /orreported"symptom distribution, and gender distribution were found to be similar in the PDD-NOS and the autism groups. Mental retardation rate and symptom severity(e.g,"poor social interaction","lack of eye contact","stereotypies")were significantly higher in the autism group with respect to the PDD-NOS group. In addition, most of the previous studies supported quantitative discrimination rather than assuming that PDD-NOS and autism are qualitatively discrete groups. Therefore, PDD-NOS may be assumed as a partial subtype of autism and that it lies on a continuum of social communication skill deficits. On the other hand, some of the studies suggest that these individuals appear to have a distinct variant of autism that does not merely sit at the less severe end of the same continuum of symptoms. They emphasize that compared to other disorders in PDD category, the children diagnosed with PDD-NOS had comparably severe but more circumscribed social communication difficulties, with fewer non-social features of autism. Therefore, we still need to investigate further the clinical features of children with PDD-NOS that distinguish them from children with autism and other non - PDD conditions
26 Autism Spectrum Disorders: The Role of Genetics in Diagnosis and Treatment Block Design and Mazes discriminated best. It was concluded that based on intelligence scores, only PDD-NOS and ADHD emerged as distinct categories, whereas the combined diagnosis did not. Allen et al. (2001) compared 18 preschool children with PDD-NOS to 176 children with autistic disorder and 311 non-autistic children with developmental language disorders (DLD) (N = 201) or low IQ (N = 110). The children with PDD-NOS did not differ significantly from either the children with autism or the children with DLD in verbal and adaptive skills. They suggested that the similarity of PDD-NOS children to autistic children in maladaptive behaviors and an intermediate position between autistic and DLD groups on virtually all measures helped to explain the difficulty clinicians encounter in classifying children with PDD-NOS (Allen et al., 2001). Rates of comorbid psychiatric conditions in children with PDD-NOS are hardly available, although these conditions are often considered as more responsive to treatment than the core symptoms of PDD-NOS (deBruin et al., 2007). In our sample (Karabekiroglu & Akbas, in press), 53.2% of the children with PDD-NOS had at least one co-morbid psychiatric disorder, including disruptive behavior disorders (40.4%), and anxiety disorders (18.0%). With respect to the PDD-NOS group, the ADHD group had significantly higher rates of comorbid disruptive behavior disorders, learning disabilities, tic disorders, elimination disorders, and social anxiety disorder. On the other hand, the PDD-NOS group had significantly higher rates of co-morbid obsessive compulsive disorder with respect to the ADHD group. In a previous study, DeBurin et al. (2007) explored the comorbidity in ninetyfour children with PDD-NOS, aged 6-12 years. At least one co-morbid psychiatric disorder was present in 80.9% of the children; 61.7% had a co-morbid disruptive behavior disorder, and 55.3% fulfilled criteria of an anxiety disorder. Compared to those without co-morbid psychiatric disorders, children with a co-morbid disorder had more deficits in social communication. 5. Conclusion The overall results suggest that children with PDD-NOS have a high number of common features with patients having autism and ADHD. The symptoms of all three diagnostic groups appeared to form three clusters, “autistic spectrum,” “ADHD spectrum,” and “anxiety spectrum.” Many features including language and motor development, “presenting” and/or “reported” symptom distribution, and gender distribution were found to be similar in the PDD-NOS and the autism groups. Mental retardation rate and symptom severity (e.g., “poor social interaction”, “lack of eye contact”, “stereotypies”) were significantly higher in the autism group with respect to the PDD-NOS group. In addition, most of the previous studies supported quantitative discrimination rather than assuming that PDD-NOS and autism are qualitatively discrete groups. Therefore, PDD-NOS may be assumed as a partial subtype of autism and that it lies on a continuum of socialcommunication skill deficits. On the other hand, some of the studies suggest that these individuals appear to have a distinct variant of autism that does not merely sit at the less severe end of the same continuum of symptoms. They emphasize that compared to other disorders in PDD category, the children diagnosed with PDD-NOS had comparably severe but more circumscribed social communication difficulties, with fewer non-social features of autism. Therefore, we still need to investigate further the clinical features of children with PDD-NOS that distinguish them from children with autism and other non-PDD conditions
Pervasive Developmental Disorder- not Otherwise Specified: Specifying and Differentiating Allen, D A, Steinberg, M, Dunn, M, Fein, D, Feinstein, C, Waterhouse, L, et al.(2001). Autistic disorder versus other pervasive developmental disorders in young children: same or different? European Child and Adolescent Psychiatry, 10(1 ): 67-78 American Psychiatric Assossiation(APA)(1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington DC: American Psychiatric Barkley, RA.(1990), A critique of current diagnostic criteria for attention deficit hyi rity disorder: cli nal of develop nd Behavioral Pediatrics 11: 343-352 Baron-Cohen, S, Wheelwright, S, Skinner, R, Martin, J- Clubley, E(2001 ). The Autism- Spectrum Quotient (AQ): Evidence from Asperger Syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31: 5-1 Bishop, S L, Richler, J, Lord, C(2006). Association between restricted and repetitive behaviors and NViQ in children with autism spectrum disorders. Child Neuropsychology, 12(4-5): 247-6 Bryson, S.A., Corrigan, S.K., McDonald, T P, Holmes Characteristics of children with autism spectrum disorders who services throug community mental health centers. Autism. 12(1): 65-82. Buitelaar, J K, Van der Gaag, R, Klin, A,& Volkmar, F.(1999), Exploring the boundaries of pervasive developmental disorder not otherwise specified: analysis of data from the DSM-IV autistic disorder field trial. Journal of Autism and Developmental Disorders. 29: 33-43 Chakrabarti, S, &x Fombonne, E(2001), Pervasive developmental disorders in preschool children. JAMA 285: 3093-3099 Cohen, D ], Volkmar, FR(2005). Autismo e disturbi generalizzati dello sviluppo Trad. It. Brescia, Vannini Editrice de Bruin, E.I., Ferdinand, R.F., Meester, S, de Nijs, P.F. Verheij, F.(2007). High rates of psychiatric co-morbidity in PDD-NOS. Journal of Autism and developmental Disorders. 37(5): 877-86 de Bruin, E L, Verheij F,& Ferdinand, RF(2006). WISC-R subtest but no overall VIQ-PIQ ifference in Dutch children with PDD-NOS. Journal of Abnormal Child Psychology, 34(2:263-71 Eaves, L.C., Ho, HH, &z Eaves, D M, (1994). Subtypes of autism by cluster analysis. Journal of Autism and Developmental Disorders, 24: 3-22 Filipek, P A Accardo, P J, Baranek, G.T., Cook E.H., Jr, Dawson, G, Gordon, B. et al. (1999), The screening and diagnosis of autistic spectrum disorders. Journal of Autism nd Developmental Disorders 29: 439-484 Gokler, B, Unal, F, Pehlivanturk, B, Cengel-Kultur, E, Akdemir, D. Taner, Y.(2004) Okul cagi cocuklarn isin duygulanim bozukluklari ve sizofreni goruisme cizelgesi simi ve asam boyu sekli-Turkse uyarlamasinin gecerlik ve guvenirligi Turkish J Child Adolesc mental health, 11(3): 109-116
Pervasive Developmental Disorder- not Otherwise Specified: Specifying and Differentiating 27 6. References Allen, D.A., Steinberg, M., Dunn, M., Fein, D., Feinstein, C., Waterhouse, L., et al. (2001). Autistic disorder versus other pervasive developmental disorders in young children: same or different? European Child and Adolescent Psychiatry, 10(1):67-78 American Psychiatric Assossiation (APA) (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington DC: American Psychiatric Assossiation. Barkley, R.A. (1990), A critique of current diagnostic criteria for attention deficit hyperactivity disorder: clinical and research implications. Journal of Developmental and Behavioral Pediatrics 11:343–352 Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The AutismSpectrum Quotient (AQ): Evidence from Asperger Syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31: 5–17 Bishop, S.L., Richler, J., & Lord, C. (2006). Association between restricted and repetitive behaviors and NVIQ in children with autism spectrum disorders. Child Neuropsychology, 12 (4-5): 247-67. Bryson, S.A., Corrigan, S.K., McDonald, T.P., & Holmes, C. (2008). Characteristics of children with autism spectrum disorders who received services through community mental health centers. Autism. 12(1):65-82. Buitelaar, J.K., Van der Gaag, R., Klin, A., & Volkmar, F. (1999), Exploring the boundaries of pervasive developmental disorder not otherwise specified: analysis of data from the DSM-IV autistic disorder field trial. Journal of Autism and Developmental Disorders, 29:33–43 Chakrabarti, S., & Fombonne, E. (2001), Pervasive developmental disorders in preschool children. JAMA 285:3093–3099 Cohen, D.J., & Volkmar, F.R. (2005). Autismo e disturbi generalizzati dello sviluppo Trad. It. Brescia, Vannini Editrice. deBruin, E.I., Ferdinand, R.F., Meester, S., de Nijs, P.F. & Verheij, F. (2007). High rates of psychiatric co-morbidity in PDD-NOS. Journal of Autism and Developmental Disorders. 37(5):877-86 deBruin, E.I., Verheij, F., & Ferdinand, R.F. (2006). WISC-R subtest but no overall VIQ-PIQ difference in Dutch children with PDD-NOS. Journal of Abnormal Child Psychology, 34(2):263-71 Eaves, L.C., Ho, H.H., & Eaves, D.M., (1994). Subtypes of autism by cluster analysis. Journal of Autism and Developmental Disorders, 24:3-22 Filipek, P.A., Accardo, P.J., Baranek, G.T., Cook E.H., Jr, Dawson, G., Gordon, B., et al. (1999), The screening and diagnosis of autistic spectrum disorders. Journal of Autism and Developmental Disorders 29:439–484 Gökler, B., Unal, F., Pehlivanturk, B., Cengel-Kultur, E., Akdemir, D., & Taner, Y. (2004). Okul çağı çocukları için duygulanım bozuklukları ve şizofreni görüşme çizelgesi - şimdi ve yaşam boyu şekli-Türkçe uyarlamasının geçerlik ve güvenirliği. Turkish J Child Adolesc Mental Health, 11 (3):109- 116