Acquired autistic behaviors in children with mucopolysaccharidosis type IIIA

Robin K Rumsey, Kyle Rudser, Kathleen Delaney, Michael Potegal, Chester B Whitley, Elsa Shapiro, Robin K Rumsey, Kyle Rudser, Kathleen Delaney, Michael Potegal, Chester B Whitley, Elsa Shapiro

Abstract

Objectives: To assess autism spectrum disorder (ASD) behaviors in children with mucopolysaccharidosis type IIIA (MPS IIIA) using a standard measure, understand the behavioral evolution of the disease, and provide specific guidelines for diagnosis.

Study design: Children (n = 21) with documented enzyme deficiency and SGSH gene mutations, cognitive age-equivalent >12 months, and early onset were administered the Autism Diagnostic Observation Schedule (ADOS) (module 1) and Bayley Scales of Infant Development-Third Edition. ADOS Social Affect and Restricted Repetitive Behavior total scores, as well as Bayley Scales of Infant Development-Third Edition cognitive age-equivalent scores, are reported using descriptive statistics and graphic presentations.

Results: Thirteen of the 21 children evaluated met the ADOS criteria for ASD/autism. ADOS score was strongly associated with age; all 11 children aged >46 months met the criteria, compared with only 2 of 10 aged <46 months. Social and affective abnormalities were most frequent; restricted interests and repetitive behaviors were largely absent. Lack of cognitive growth paralleled ADOS score.

Conclusion: An increased incidence of ASD-like social behaviors was seen at age 3-4 years in children with early-onset MPS IIIA. Although more frequent in the severely impaired children, ASD-like behaviors were observed across the entire range of cognitive impairment. Clinicians must be aware that when a child acquires ASD-like behaviors, MPS IIIA should be included in the differential diagnosis.

Trial registration: ClinicalTrials.gov NCT01047306.

Conflict of interest statement

The other authors declare no conflicts of interest.

Copyright © 2014 Elsevier Inc. All rights reserved.

Figures

Figure 1
Figure 1
Scatterplot of chronological age (a) and cognitive age-equivalent (b) against total ADOS score. Higher ADOS scores indicate more behaviors compatible with ASD.
Figure 1
Figure 1
Scatterplot of chronological age (a) and cognitive age-equivalent (b) against total ADOS score. Higher ADOS scores indicate more behaviors compatible with ASD.

Source: PubMed

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