For disorders like autism

where highly unusual behaviors or developmental features are sampled there can be special problems for developing and using dimensional assessments. However, a considerable body of work now exists on their use both for purposes of screening and diagnosis.8,9 And now some of these PRT062607 order approaches have been used to “crosswalk” back to categorical ones. In autism and related conditions dimensional approaches Inhibitors,research,lifescience,medical have taken various forms. For example, instruments designed to assess normative development, eg, of intelligence, communication, motor development, and adaptive behavior are widely used.10,11 Such instruments provide information that can be used both to monitor progress to refine interventions and may also inform issues of diagnosis. As noted, subsequent differences in psychological profiles may mark different Inhibitors,research,lifescience,medical expressions of the autism phenotype, eg, with individuals with Asperger’s disorder exhibiting rather different profiles compared with those with classical autism.12 One of these instruments, the Vineland Adaptive Behavior Scales, has also been used as a screening tool and

had considerable utility in discriminating individuals with and without autism.13 Other instruments focus on behaviors or features Inhibitors,research,lifescience,medical more specific to autism, eg, specific symptoms, behavioral ratings, or historical information. These can be provided based on direct assessment of the individual, parent or teacher report, or both. Some of these instruments are designed for screening and others for diagnostic purposes. 8,14 Challenges for instruments of this type relate, as do categorical Inhibitors,research,lifescience,medical approaches, to the balance of sensitivity and specificity, as well as much more complex problems of sampling, instrument design, and

so forth. Issues of how intense, frequent, and disabling Inhibitors,research,lifescience,medical symptoms are become important as do aspects of informant bias. For some of the best of these instruments the training requirements and length of administration time may limit use in actual practice (again highlighting the tension between research and clinical use of classification systems). Historical development of diagnostic concepts Infantile autism Kanner’s clinical description of children with “autistic disturbances of affective contact” has proven enduring.1 He was a careful phenomenologist in the days before next the importance of an a theoretical approach was emphasized.15 His description was also carefully grounded in available child development research, eg, he emphasized how normal infants exhibit marked interest in social interaction from early in life. Kanner suggested that the condition he described was inborn, and that the children he had seen exhibited a curious lack of interest in the social environment combined with an increased interest in the nonsocial environment.