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      A Comparison of the Autism Treatment Evaluation Checklist (ATEC) and the Childhood Autism Rating Scale (CARS) for the Quantitative Evaluation of Autism

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          Abstract

          The purpose of this study was to evaluate scores generated from the Autism Treatment Evaluation Checklist (ATEC), a parent-rated measure, and those derived from professionally completed Childhood Autism Rating Scale (CARS) evaluations. A cohort of 56 participants diagnosed with an autism spectrum disorder was used for the study, and each child was evaluated independently by the parent using the ATEC and a health care professional using the CARS. The Spearman's rank correlation statistic ρ was used to evaluate the correlation between ATEC and CARS scores. It was observed that there was a significant correlation between total ATEC and CARS scores (ρ = .71). Specific domains in the ATEC evaluation significantly correlated with CARS scores. Sensitivity, specificity, and receiver operating characteristic confirmed the association between CARS and ATEC domains. The results help to validate the utility of the parentally completed ATEC in comparison with an established, professional-related measure of autism.

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          Gastrointestinal flora and gastrointestinal status in children with autism -- comparisons to typical children and correlation with autism severity

          Background Children with autism have often been reported to have gastrointestinal problems that are more frequent and more severe than in children from the general population. Methods Gastrointestinal flora and gastrointestinal status were assessed from stool samples of 58 children with Autism Spectrum Disorders (ASD) and 39 healthy typical children of similar ages. Stool testing included bacterial and yeast culture tests, lysozyme, lactoferrin, secretory IgA, elastase, digestion markers, short chain fatty acids (SCFA's), pH, and blood presence. Gastrointestinal symptoms were assessed with a modified six-item GI Severity Index (6-GSI) questionnaire, and autistic symptoms were assessed with the Autism Treatment Evaluation Checklist (ATEC). Results Gastrointestinal symptoms (assessed by the 6-GSI) were strongly correlated with the severity of autism (assessed by the ATEC), (r = 0.59, p < 0.001). Children with 6-GSI scores above 3 had much higher ATEC Total scores than those with 6-GSI-scores of 3 or lower (81.5 +/- 28 vs. 49.0 +/- 21, p = 0.00002). Children with autism had much lower levels of total short chain fatty acids (-27%, p = 0.00002), including lower levels of acetate, proprionate, and valerate; this difference was greater in the children with autism taking probiotics, but also significant in those not taking probiotics. Children with autism had lower levels of species of Bifidobacter (-43%, p = 0.002) and higher levels of species of Lactobacillus (+100%, p = 0.00002), but similar levels of other bacteria and yeast using standard culture growth-based techniques. Lysozyme was somewhat lower in children with autism (-27%, p = 0.04), possibly associated with probiotic usage. Other markers of digestive function were similar in both groups. Conclusions The strong correlation of gastrointestinal symptoms with autism severity indicates that children with more severe autism are likely to have more severe gastrointestinal symptoms and vice versa. It is possible that autism symptoms are exacerbated or even partially due to the underlying gastrointestinal problems. The low level of SCFA's was partly associated with increased probiotic use, and probably partly due to either lower production (less sacchrolytic fermentation by beneficial bacteria and/or lower intake of soluble fiber) and/or greater absorption into the body (due to longer transit time and/or increased gut permeability).
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            Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS).

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              Underdevelopment of the postural control system in autism.

              To determine if abnormalities exist in postural control in autism and if they are related to age. Dynamic posturography was performed in 79 autistic individuals without mental retardation and 61 healthy volunteers between ages 5 and 52 years. Both the sensory organization and the movement coordination portions of the test were performed. The autistic subjects had reduced postural stability (p = 0.002). Examination of age effects revealed that the development of postural stability was delayed in the autistic subjects (p < 0.001) and failed to achieve adult levels (p = 0.004). Postural stability was reduced under all conditions but was clinically significant only when somatosensory input was disrupted alone or in combination with other sensory challenges (mean reduction in stability of 2.6 +/- 1.0 for the first three conditions without somatosensory disruption vs 6.7 +/- 2.7 for the last three conditions with somatosensory disruption), indicating problems with multimodality sensory integration. The evidence from this and studies of the motor system suggests more general involvement of neural circuitry beyond the neural systems for social behavior, communication, and reasoning, all of which share a high demand on neural integration of information.
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                Author and article information

                Journal
                J Ment Health Res Intellect Disabil
                J Ment Health Res Intellect Disabil
                umid
                Journal of Mental Health Research in Intellectual Disabilities
                Taylor & Francis
                1931-5864
                1931-5872
                3 July 2013
                October 2013
                : 6
                : 4
                : 255-267
                Affiliations
                Institute of Chronic Illnesses, Inc., Silver Spring, Maryland
                University of Texas Southwestern Medical Center, Dallas, Texas
                ASD Centers, LLC, Silver Spring, Maryland
                Author notes
                Address correspondence to Janet K. Kern, Institute of Chronic Illnesses, Inc., 14 Redgate Court, Silver Spring, MD 20905. E-mail: jkern@ 123456dfwair.net
                Article
                10.1080/19315864.2012.681340
                3725669
                23914277
                e4b54818-8b8a-47ed-be88-eaa81f2f1297
                © Taylor & Francis Group, LLC

                This is an open access article distributed under the Supplemental Terms and Conditions for iOpenAccess articles published in Taylor & Francis journals , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Research Article

                asd,asperger's,autistic disorder,pdd-nos,cars,atec
                asd, asperger's, autistic disorder, pdd-nos, cars, atec

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