The Children's Communication Checklist (CCC) was developed to assess aspects of communicative impairment that are not adequately evaluated by contemporary standardised language tests. These are predominantly pragmatic abnormalities seen in social communication, although other qualitative aspects of speech and language were also included. Some items covering social relationships and restricted interests were incorporated, so that the relationship between pragmatic difficulties and other characteristics of pervasive developmental disorders could be explored. Checklist ratings were obtained for 76 children aged 7 to 9 years, all of whom had received special education for language impairment. In 71 cases, 2 raters (usually a teacher and speech-language therapist) independently completed the checklist, making it possible to establish inter-rater reliability. From an initial pool of 93 items, 70 items, grouped into 9 scales, were retained. Five of the subscales were concerned with pragmatic aspects of communication. A composite pragmatic impairment scale formed from these subscales had inter-rater reliability and internal consistency of around .80. This composite discriminated between children with a school diagnosis of semantic-pragmatic disorder and those with other types of specific language impairment (SLI). The majority of children with pragmatic language impairments did not have any evidence of restricted interests or significant difficulties in the domains of social relationships.

This study reconsiders the relationship of childhood Attention Deficit/Hyperactivity Disorder (ADHD) and childhood conduct problems with adult criminal activity by clarifying the role of the cardinal behaviors associated with the DSM-IV ADHD subtypes (inattention and hyperactivity/impulsivity). Since their childhood (average age 9 years), 230 male and 75 female subjects have been followed prospectively and were interviewed as young adults (average age 26 at follow-up). Early childhood behavior ratings by parents and teachers were examined to determine the role of conduct problems, hyperactivity-impulsivity, and inattention in predicting adult criminal involvement as measured by both official arrest records and self-report. Results show that both hyperactivity-impulsivity and early conduct problems independently, as well as jointly, predict a greater likelihood of having an arrest record for males, but not for females. For male subjects with 10 or more self-reported crimes, both early conduct problems and hyperactivity-impulsivity were significant predictors, both alone and in combination. Therefore, it appears that predominantly the symptoms of hyperactivity-impulsivity, but not inattention, contribute to the risk for criminal involvement over and above the risk associated with early conduct problems alone.

In this selective review of recent research on internalizing disorders in childhood, we focus on four areas: the predictive validity of the diagnoses of depressive and anxiety disorders, rates of comorbidity, the chronology of onsets of the disorders of interest, and transmission of depressive and anxiety disorders in the pedigrees of affected individuals. To synthesize and reconcile findings in these four areas, we approach the information from a developmental perspective and assume that genetically driven biologic processes play a salient role in the expression of depressive and anxiety disorders in childhood. We also comment on the relevance of findings on children and adolescents to the field of depressive and anxiety disorders in adults and make recommendations for further research.

Previous twin and family studies have indicated that there are strong genetic influences in the etiology of autism, and provide support for the notion of a broader phenotype in first-degree relatives. The present study explored this phenotype in terms of one current cognitive theory of autism. Parents and brothers of boys with autism, boys with dyslexia, and normal boys were given tests of “central coherence”, on which children with autism perform unusually well due to an information-processing bias favouring part/detail processing over processing of wholes/meaning. Results indicated that fathers of boys with autism, as a group, showed piecemeal processing across four tests of central coherence. This was not true for any other group. These findings raise the possibility that the broader autism phenotype may include a “cognitive style” (weak central coherence) that can confer information-processing advantages.

This annotation presents an integrative model of the origins and development of antisocial behavior during childhood and adolescence. Like all theoretical models, it both summarizes what is known and states hypotheses that go beyond the current data. Our goal is to add to the impetus created by other theories to conduct the critical studies necessary to test models and advance knowledge. The present model offers some new hypotheses regarding precursors to antisocial behavior but seeks primarily to integrate antisocial propensity theories (Gottfredson & Hirschi, 1990) and developmental theories (Loeber, 1988; Moffitt, 1993; Patterson, Reid, & Dishion, 1992). Our model focuses on enduring propensities to antisocial behavior but also places antisocial propensity within a developmental perspective. Like Loeber (1991) and Sroufe (1997), we posit that changing manifestations of problem behavior over the course of the development result from successive transactions of the growing child with changing social environments. As such, roles for person variables, developmental variables, and environment variables are specified, as are interactionsWe use the term "interaction" broadly in discussing the interplay between predisposing variables and social experiences. We have not advanced hypotheses at this point that distinguish between additive, multiplicative, or other joint effects of these classes of variables, but joint effects beyond additive combinations would be most consistent with the intent of our model (cf. Pennington & Bennetto, 1993). among these classes of variables. The age of onset of antisocial behavior is a key element of the present model as the levels of influences from the multiple causal factors vary with the age of onset of antisocial behavior. Because much more is known about antisocial behavior in boys than girls, the present model may be applicable only to boys. As discussed in this annotation, there may be important gender differences that will require different models for girls and boys. Therefore, when sufficient data are available, it will be important to test the applicability of the model to girls.

The present study investigated longitudinal pathways from specific early preschool behavioral problems (ages 2–3 years) to internalizing and externalizing problems in preadolescence (ages 10–11 years), and the role of social problems at school entry (ages 4–5 years) in such pathways. Path analyses were performed using both parent and teacher reports in a sample of 251 to 346 children from the general population, depending on the availability of parent and teacher data at each time of assessment. Structural equation modeling revealed homotypic internalizing and externalizing pathways, predictions from early preschool externalizing problems to later internalizing problems, and negative predictive paths from early internalizing problems to externalizing problems in preadolescence. Cross-informant predictions spanning 8 years were found between parent-reported aggression and overactivity at ages 2–3 years and teacher-reported externalizing problems at ages 10–11 years. Further, results showed that boys' pathways were more complex and showed greater predictive validity than pathways for girls, and that social problems at school entry played a significant role in pathways to internalizing problems, but only for boys. The results are discussed from a developmental psychopathology perspective.

Factors influencing the rate, form, and severity of phenotypic expression among relatives of autistic probands are examined. Family history data on 3095 first- and second-degree relatives and cousins from 149 families with a child with autism and 36 families with a child with Down syndrome are studied. The results provide further evidence of an increased risk among autism relatives for the broadly defined autism phenotype. Of proband characteristics, severity of autism and obstetric optimality were confirmed as being related to familial loading for probands with speech. There was little variation in loading among probands lacking speech. The type of phenotypic profile reported in relatives appeared little influenced by characteristics of the relative or the proband, except for variation by degree of relative, parental status of relative, and perhaps proband's birth optimality score. Phenotypic rates among parents suggested reduced fitness for the severest and more communication-related forms of expression but not for the more mild and social forms of expression. Patterns of expression within the families did not support a simple X-linked nor an imprinted X-linked mode of inheritance. The basis for sex differences in rates of expression is discussed.

Annual screenings of preschool children at kindergarten registration identified 158 children having high levels of aggressive, hyperactive, impulsive, and inattentive behavior. These “disruptive” children were randomly assigned to four treatment conditions lasting the kindergarten school year: no treatment, parent training only, full-day treatment classroom only, and the combination of parent training with the classroom treatment. Results showed that parent training produced no significant treatment effects, probably owing largely to poor attendance. The classroom treatment produced improvement in multiple domains: parent ratings of adaptive behavior, teacher ratings of attention, aggression, self-control, and social skills, as well as direct observations of externalizing behavior in the classroom. Neither treatment improved academic achievement skills or parent ratings of home behavior problems, nor were effects evident on any lab measures of attention, impulse control, or mother–child interactions. It is concluded that when parent training is offered at school registration to parents of disruptive children identified through a brief school registration screening, it may not be a useful approach to treating the home and community behavioral problems of such children. The kindergarten classroom intervention was far more effective in reducing the perceived behavioral problems and impaired social skills of these children. Even so, most treatment effects were specific to the school environment and did not affect achievement skills. These findings must be viewed as tentative until follow-up evaluations can be done to determine the long-term outcomes of these interventions.

This article reviews recent advances in understanding the changes in memory function that take place during the childhood years. Development of the following aspects of memory are considered: short-term memory, comprising phonological memory, visuospatial memory, and executive function; autobiographical memory; episodic memory, including eyewitness memory; and metamemory. Each of these aspects of memory function shows substantial qualitative change from infancy, through the preschool period, to the early school years. Beyond about 7 years of age, however, memory function appears adult-like in organisation and strategies, and shows only a gradual quantitative improvement through to early adolescence.

This paper reports the literacy skills of 63 children selected as being at genetic risk of dyslexia compared with 34 children from families reporting no history of reading impairment. Fifty-seven per cent of the at-risk group were delayed in literacy development at 6 years compared with only 12% of controls. The “unimpaired” at-risk group were not statistically different from controls on most cognitive and language measures at 45 months, whereas the literacy-delayed group showed significantly slower speech and language development, although they did not differ from controls in nonverbal ability. Letter knowledge at 45 months was the strongest predictor of literacy level at 6 years. In addition, early speech and language skills predicted individual differences in literacy outcome and genetic risk accounted for unique variance over and above these other factors. The results are discussed in terms of an interactive developmental model in which semantic and phonological skills support early reading acquisition.

The science of reading and developmental dyslexia has experienced spectacular advances during the last few years. Five aspects of this research are discussed in the article. (1) The holistic phenomenon of reading is complex. Many lower-level psychological processes (e.g., phonemic awareness, phonological decoding, ability to process stimuli rapidly and automatize this process, memory, ability to recognize words) contribute to a single act of reading. Conceptualizing the complex process of reading through its partly overlapping but partly independent components—which contribute to, but do not fully explain, the holistic process of reading—provides an excellent model for understanding complex hierarchies of higher mental functions. Those who master reading skills successfully and those who have difficulties doing so differ in a wide range of reading-related processes. The central deficit experienced by poor readers appears to be related to phonological processing (a complex hierarchy of functions related to processing phonemes), whereas characteristics of automatization processes seem to moderate the reading outcome for people whose phonological skills are weak. (2) There are new data addressing models of dyslexia in languages other than English. The most fascinating finding is that the model implicating phonological deficit as central to dyslexia, and the lack of ability to automatize as leading to troubled reading, appears to be universal, regardless of the specific language. However, there is an interaction effect between the characteristics of a particular language and the developmental model of dyslexia. In phonologically more difficult languages (e.g., English), the most pronounced weakness appears to occur in phonological processing, whereas in phonologically easier languages (e.g., German), the crucial role in the manifestation of dyslexia is played by the lack of the skills needed to achieve automatization. (3) There is abundant evidence that reading (i.e., any single act of reading as well as reading as a holistic process) is ‘‘cooked'' by the brain. Although no unified brain map of reading has been developed, some specific areas of the brain have been implicated in different reading-related cognitive processes by different laboratories and on different samples. (4) Indisputable evidence has been accumulated suggesting the involvement of the genome in developmental dyslexia. As of now, specific regions of the genome have been identified as being intimately involved with a number of different reading-related processes. Today the field of developmental dyslexia is the only area of genetic studies of human abilities and disabilities in which linkages to the genome have been robustly replicated in independent laboratories. (5) Finally, evidence suggests that developmental dyslexia might be only one of the manifestations of a deep, underlying, anatomical syndrome. The comorbidity of developmental dyslexia with both internalizing and externalizing behavioral disturbances, as well as with other learning disabilities, underscores the need for wide-ranging cognitive and behavioral approaches in the remediation programs offered to dyslexic children.

Thirteen children and adolescents with diagnoses of Asperger syndrome (AS) were matched with 13 nonautistic control children on chronological age and verbal IQ. They were tested on their ability to recognize simple facial emotions, as well as facial emotions paired with matching, mismatching, or irrelevant verbal labels. There were no differences between the groups at recognizing simple emotions but the Asperger group performed significantly worse than the control group at recognizing emotions when faces were paired with mismatching words (but not with matching or irrelevant words). The results suggest that there are qualitative differences from nonclinical populations in how children with AS process facial expressions. When presented with a more demanding affective processing task, individuals with AS showed a bias towards visual-verbal over visual-affective information (i.e., words over faces). Thus, children with AS may be utilizing compensatory strategies, such as verbal mediation, to process facial expressions of emotion.

The aim of the present study was to follow up the long-term course of adolescent-onset anorexia nervosa by repeated assessment, to analyze the association between the course of the eating disorder and psychiatric comorbidity, and to evaluate psychosocial outcome. The sample consisted of 39 inpatients who were reinvestigated 3, 7, and 10 years after discharge. The patients and 39 controls matched for age, gender, and occupational status were assessed with structured interviews on DSM-III-R eating disorders, additional axis I and axis II psychiatric disorders, and psychosocial functioning. Results showed that 69% of the original subjects met the criteria for full recovery at the 10-year follow-up. One patient (3%) still exhibited the full syndrome of restrictive anorexia nervosa, two patients (5%) the full syndrome of bulimia nervosa. None of the patients had died. Of the subjects, 51% currently had an axis I psychiatric disorder and 23% met the full criteria for a personality disorder. Apart from the eating disorder, anxiety disorders and avoidant-dependent and obsessive-compulsive personality disorders were the most common psychiatric diagnoses. There was a significant association between psychiatric comorbidity and the outcome of the eating disorder and between outcome and psychosocial adaptation. With regard to psychiatric morbidity and psychosocial functioning, long-term recovered patients did not differ significantly from normal controls. It is concluded that in most patients adolescent anorexia nervosa takes a prolonged course, although it seems to be more favorable than in adult-onset forms. Those who achieve complete recovery from the eating disorder have a good chance of overcoming other psychiatric disorders and to adapt to social requirements.

The Quebec Child Mental Health Survey (QCMHS) was conducted in 1992 on a representative sample of 2400 children and adolescents aged 6 to 14 years from throughout Quebec. Prevalences of nine Axis-I DSM-III-R (American Psychiatric Association, 1987) mental health disorders were calculated based on each informant (for 6–11-year-olds: child, parent, and teacher; for 12–14-year-olds: child and parent). Informant parallelism allows the classification of results of the demographic variables associated with disorders in the logistic regression models. This strategy applies to group variables (correlates of disorders) whereas informant agreement applies to individual diagnoses. Informant parallelism implies that results for two informants or more are in the same direction and significant. In the QCMHS, informant parallelism exists for disruptive disorders, i.e. in two ADHD regression models (child and parent) higher rates among boys and young children, and in three oppositional/conduct disorders regression models (child, parent, and teacher) higher rates among boys. No informant parallelism is observed in the logistic regression models for internalizing disorders, i.e. the patterns of association of demographic variables with anxiety and depressive disorders vary across informants. Urban-rural residence does not emerge as a significant variable in any of the logistic regression models. The overall 6-month prevalences reach 19.9% according to the parent and 15.8% according to the child. The implications of the results for policy makers and clinicians are discussed.

Key substantive findings from quantitative and molecular genetic research are reviewed in relation to affective disorder, schizophrenia, autism, hyperkinetic/attention deficit disorder, oppositional and conduct disorders, drug/alcohol problems, and Tourette's syndrome/chronic tics.

A meta-analysis was conducted to identify information processing factors that characterise children with Developmental Coordination Disorder (DCD). A total of 50 studies yielded 374 effect sizes based on 983 DCD and 987 control children. A mild generalised performance deficit was indicated, since motor-impaired children were inferior on almost all measures of information processing. There were, however, several areas where their deficiencies were more pronounced. The greatest deficiency was in visual-spatial processing. This was evident regardless of whether or not the tasks involved a motor component. Most other deficiencies were in the small-to-moderate range and included kinaesthetic and cross-modal processing. The findings support the notion that perceptual problems, particularly in the visual modality, are associated with difficulties in motor coordination.

Children with autism are known to have difficulties in sharing attention with others. Yet one joint attention behaviour, the ability to follow another person's head turn and gaze direction, may be achieved without necessarily sharing attention. Why, then, should autistic children have difficulties with it? In this study we examined the extent of this difficulty by testing school-aged autistic children across three different contexts; experiment, observation, and parent interview. We also tested whether the ability to orient to another person's head and gaze could be facilitated by increasing children's attention to environmental targets and social cues. Results for experiment and observation demonstrate that a sizeable proportion of children with autism did not have difficulties with following another's head turn. There was a difference between children with high and low verbal mental ages, however. Whereas children with higher mental ages (over 48 months) were able to orient spontaneously to another person's head turn, children with lower mental ages had difficulties with this response. When cues were added (pointing, language) or when feedback from targets was given, however, their performance improved. Parent interview data indicated that children with autism, whatever their mental age, began to follow head turn and gaze direction years later than typically developing children. Developments in attention and language are proposed as possible factors to account for this developmental delay.

Spontaneous shifts of attention were observed in autistic, typically developing, and nonautistic developmentally delayed infants. Three types of attention shifting behaviour were observed; (1) between an object and another object, (2) between an object and a person, and (3) between a person and another person. The two control groups shifted attention more frequently between an object and a person than between an object and another object or between a person and another person. The infants with autism showed a different pattern, shifting attention between an object and another object more than any other type of shift. Furthermore, infants with autism showed fewer shifts of attention between an object and a person, and between person and person, than did the two control groups. They also spent less time overall looking at people and looked more briefly at people and for longer durations at objects, compared to the two control groups. These results indicate an abnormality in social orientation in autism even at the early age of 20 months.

A population-based sample of Norwegian children aged 18 months (N=921), 30 months (N=784), and 50 months (N=737) was examined with the EAS Temperament Survey (Buss & Plomin, 1984). The factor structure, psychometric properties, and stability estimates of the instrument were assessed. A cross-validation of the temperament factors of Emotionality, Activity, and Shyness show that the covariance structure conforms with the three scales described by Rowe and Plomin (1977) and Boer and Westenberg (1994). When items from the experimental scale of Sociability were included in the analysis, a four-factor solution confirmed the separate usability of this scale as well. The factor structure does not seem to vary substantially with the age of the children. The scores on the four temperament scales show high stability from one time of measurement to the next. Although no strong gender differences were found, there were significant age trends. Emotionality and Shyness increased from 18 to 50 months, while Activity and Sociability decreased. The study confirmed the structure and stability of the EAS over 3 years among young children, providing support for its use with children as young as 18 months.

Objective: To evaluate sleep and alertness and to investigate the presence of possible underlying sleep/wake disorders in children with attention-deficit/hyperactivity disorder (ADHD). Method: After 3 nights of adaptation in a room reserved for sleep studies in the department of child psychiatry, children underwent polysomnography (PSG) followed by the Multiple Sleep Latency Test (MSLT) and reaction time tests (RT) during the daytime. Thirty boys diagnosed as having ADHD (DSM-IV), aged between 5 and 10 years, and 22 age- and sex-matched controls participated in the study. All children were medication-free and showed no clinical signs of sleep and alertness problems. Results: No significant differences in sleep variables were found between boys with ADHD and controls. The mean latency period was shorter in children with ADHD. Significant differences were found for MSLT 1, 2 and 3 (p<.05). Mean reaction time was longer in children with ADHD, with significant differences in all tests (p<.05). Number and duration of sleep onsets measured by the MSLT correlated significantly with the hyperactivity-impulsivity and inattentive- passivity indices of the CTRS and CPRS. Conclusion: Children with ADHD were more sleepy during the day, as shown by the MSLT, and they had longer reaction times. These differences are not due to alteration in the quality of nocturnal sleep. The number of daytime sleep onsets and the rapidity of sleep-onsets measured as MSLT were found to be pertinent physiological indices to discriminate between ADHD subtypes. These results suggest that children with ADHD have a deficit in alertness. Whether this deficit is primary or not requires further studies.