?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.title=Childhood+autism%3A+an+appeal+for+an+integrative+and+psychobiological+approach&rft.creator=Oades%2C+Robert+D.&rft.creator=Eggers%2C+C.&rft.subject=Clinical+Psychology&rft.subject=Neuropsychiatry&rft.subject=Psychobiology&rft.description=Introduction%3A+Childhood+autism%2C+overtly+expressed+as+social+indifference+and+repetitive+motor+patterns%2C+in+fact+involves+a+range+of+problems+covering+sensory%2C+attentional%2C+cognitive%2C+emotional%2C+language+as+well+as+motor+areas+of+function+-+25+symptoms+can+be+listed.+Although+a+reduced+verbal+IQ+and+language+difficulties+are+frequent%2C+a+major+intervening+variable+may+be+problems+with+the+development+of+a+%22theory-of-mind%22+....the+ability+to+comprehend+the+mental+states+of+others.+Prevalence+rates+per+10%2C000+of+the+population+range+from+2+to+16+in+different+countries%2C+rising+to+50+if+one+includes+spectrum+autistic+disorder.+A+number+of+sometimes+related+organic+associations+and+potentially+separate+aetiologies+are+described.%0A%0ABiology%3A+Evidence+for+delayed+neurotransmission+(evoked+potentials)+and+a+lack+of+flexibility+in+physiological+responses+(signal+detection%2C+cross-modal+integration)+may+underlie+the+attenuation+of+monitoring+processes+that+lead+to+withdrawal+and+stereotypies.+Neuropsychological+task+performance+provides+limited+and+qualified+evidence+for+impaired+frontal+function%2C+although+this+could+explain+event-related+potential+(ERP)+evidence+for+more+of+a+deficit+with+controlled+attention+(Nd)+than+in+automatic+processing+(MMN).+%5BERPs+also+underline+the+difficulties+in+generating+differential+responses+to+relevant+and+irrelevant+stimuli.%5D+Imaging+studies+show+some+structural+abnormalities+in+half+the+patients+(e.g.+ventricle+volume+increases)%2C+but+indices+of+activation%2C+though+in+the+normal+range+do+not+appear+situation-appropriate.+%0A%0APharmacology%3A+%0Aa)+A+significant+proportion+of+autistic+subjects+show+increased+peripheral+measures+of+serotonin+and+quite+often+raised+dopamine+metabolism+-+that+in+some+high-functioning+cases+has+been+claimed+to+be+beneficial.+It+is+plausible+that+changes+in+monoaminergic+transmission+are+inadequately+compensated+by+changes+in+the+other+transmitter+systems.+%0Ab)+With+serotonin+and+dopamine+responsible+for+inhibition%2Fvolume-control+and+for+switching%2Fflexibility+we+propose+an+imbalance+of+these+systems+that+results+in+a+stop-go+form+of+neuronal+communication+that+inevitably+leads+to+anomalous+responses+at+the+whole+organism+level.%0Ac)+At+least+20+forms+of+pharmocotherapy+have+been+attempted%2C+the+best+with+improvement+limited+to+a+few+patients+improving+particular+symptoms+only.+The+best+have+proved+to+be+dopamine+or+opioid+antagonists%2C+but+at+best+-+these+have+a+limited+and+modest+role+to+play+in+clinical+care%0A%0A%0AConclusions%3A+The+impairment+of+children+with+autism+manifests+itself+at+many+levels+-+treatment+concepts+must+attempt+to+integrate+these%2C+with+emphasis+on+the+particular+abilities+and+difficulties+of+the+individual.+The+need+is+to+synthesize+the+different+levels+of+analysis+for+a+psychobiological+approach+to+be+integrated+into+the+wide-ranging+remedial+programmes+currently+practised..%0A%0A&rft.publisher=Hogrefe+%26+Huber&rft.date=1994&rft.type=Journal+(Paginated)&rft.type=PeerReviewed&rft.format=application%2Fpdf&rft.identifier=http%3A%2F%2Fcogprints.org%2F1269%2F2%2FAut-Rev-1994.pdf&rft.identifier=++Oades%2C+Robert+D.+and+Eggers%2C+C.++(1994)+Childhood+autism%3A+an+appeal+for+an+integrative+and+psychobiological+approach.++%5BJournal+(Paginated)%5D+++++&rft.relation=http%3A%2F%2Fcogprints.org%2F1269%2F