Developmental Disorders

Program Members

Program Description

In April, 2008, an independent Developmental Disorders ( DD) Program was established in the Dept. of Psychiatry at UBC; distinct from both Child and Adolescent Psychiatry and Neuropsychiatry, but with components from both areas. The preliminary discussions around this Program, were hosted by Trevor Young ( Head of Psychiatry at UBC) and attended by Trevor Hurwitz ( Director of Neuropsychiatry Program), Jana Davidson ( Director of Child and Adolescent Psychiatry Program), Jon Fleming ( residency training director) and Robin Friedlander ( currently Director of the DD Program).

The term Developmental Disorders is an umbrella term, which refers to disorders of the developing nervous system , resulting in impaired intellectual and/ or adaptive functioning.

This refers to Children, youth and adults who have significantly greater difficulty than most people with intellectual and adaptive functioning and have had such difficulties from a very early age (or the developmental period prior to age 18). ‘Adaptive functioning’ means carrying out everyday activities such as communicating and interacting with others, managing money, doing household activities and attending to personal care.

This definition of developmental disorder includes children, youth and adults with Autism Spectrum Disorders, Fetal Alcohol Spectrum Disorders and other genetic and metabolic syndromes.

Why is this an area of importance for Psychiatrists and other Mental Health Professionals?

Compared to the general population, individuals with developmental disability have a much higher rate of psychiatric disorders, yet are typically under diagnosed, misdiagnosed, and/or underserved. It is imperative that we aim to improve mental health outcomes for these individuals, their families, and caregivers.

 

In British Columbia, long-stay institutions for people with developmental disorders have been closed. In 1981, the government announced a commitment to the closures of all long stay institutions for people with developmental disabilities. The aim of the policy of deinstitutionalization was to provide services closer to home.

Tranquille, in the Interior of BC was closed in 1985 and over the next ten years, the institutions of Glendale and Woodlands were closed and individuals moved to the community.

With these closures, specific health and social care protocols were developed between the Ministry of Health (now Ministry of Health Services) and the Ministry of Social Services.

These Ministries created two community based programs , to support people with developmental disorders:

  • Health Services for Community Living (HSCL)
  • Mental Health Support Teams (MHST)

These programs are currently operated and managed by Health Authorities. Health Services for Community Living provides consultation in the areas of home nursing, physiotherapy and occupational therapy as well as nutrition and dental care. The Mental Health Support Teams provide assessment, treatment and consultation for those individuals with developmental disorders and mental health needs who need special attention through Mental Health and Addiction Services.

It is important to note that in BC, access to publicly funded community services for individuals with Developmental Disorders, is only available to those whose IQ is < 70 – 75 ; i.e. within the Intellectual Disability range of functioning ( according to DSM IV criteria for Mental Retardation)

Successful community living requires not just a linkage of community residential and day supports, but also a health care system that is informed and responsive to the needs of this population. Over the last three decades, knowledge concerning the mental health needs of this population has increased significantly leading to a better understanding of service needs and growing international consensus on key elements of an adequate and responsive health service system.

Published Articles in Refereed Journals, Peer Reviewed

Falter CM, Elliott MA, Bailey AJ. Enhanced visual temporal resolution in autism spectrum disorders. PLoS One. 2012;7(3):e32774. Epub 2012 Mar 21. PubMed  PMID: 22470425; PubMed Central PMCID: PMC3309999.cker C, Suckling J, Deoni SC, Lombardo MV, Bullmore ET, Baron-Cohen S, Catani M, Jezzard P, Barnes A, Bailey AJ, Williams SC, Murphy DG; for the MRC AIMS Consortium. Brain Anatomy and Its Relationship to Behavior in Adults With Autism Spectrum Disorder: A Multicenter Magnetic Resonance Imaging Study. Arch Gen Psychiatry. 2012 Feb;69(2):195-209.

Klliäinen A, Wallace S, Coutanche MN, Leppänen JM, Cusack J, Bailey AJ, Hietanen JK. Affective-motivational brain responses to direct gaze in children with autism spectrum disorder. J Child Psychol Psychiatry. 2012 Jan 25. doi:10.1111/j.1469-7610.2011.02522.x. [Epub ahead of print]

Bailey AJ. Autism in adults. Autism Res. 2012 Feb;5(1):1-2. doi: 10.1002/aur.233. Epub 2011 Dec 9. PubMed PMID: 22162402.

Moss S., Friedlander R. (2011). Psychiatric Assessment Schedules for Adults with Developmental Disabilities (PAS-ADD); clinical interview for the assessment of mental health problems in people with intellectual disability.

Parr JR, Le Couteur A, Baird G, Rutter M, Pickles A, Fombonne E, Bailey AJ; The International Molecular Genetic Study of Autism Consortium (IMGSAC). Early Developmental Regression in Autism Spectrum Disorder: Evidence from an International Multiplex Sample.  J Autism Dev Disord. (2011) 41(3): 332-340.

Anney RJ, Kenny EM, O’Dushlaine C, Yaspan BL, Parkhomenka E; The Autism Genome Project, Buxbaum JD, Sutcliffe J, Gill M, Gallagher L; The AGP Members, Bailey AJ, Fernandez BA, Szatmari P, Scherer SW, Patterson A, Marshall CR, Pinto D, Vincent JB, Fombonne E, Betancur C, Delorme R, Leboyer M, Bourgeron T, Mantoulan C, Roge B, Tauber M, Freitag CM, Poustka F, Duketis E, Klauck SM, Poustka A, Papanikolaou K, Tsiantis J, Gallagher L, Gill M, Anney R, Bolshakova N, Brennan S, Hughes G, McGrath J, Merikangas A, Ennis S, Green A, Casey JP, Conroy JM, Regan R, Shah N, Maestrini E, Bacchelli E, Minopoli F, Stoppioni V, Battaglia A, Igliozzi R, Parrini B, Tancredi R, Oliveira G, Almeida J, Duque F, Vicente A, Correia C, Magalhaes TR, Gillberg C, Nygren G, Jonge MD, Van Engeland H, Vorstman JA, Wittemeyer K, Baird G, Bolton PF, Rutter ML, Green J, Lamb JA, Pickles A, Parr JR, Couteur AL, Berney T, McConachie H, Wallace S, Coutanche M, Foley S, White K, Monaco AP, Holt R, Farrar P, Pagnamenta AT, Mirza GK, Ragoussis J, Sousa I, Sykes N, Wing K, Hallmayer J, Cantor RM, Nelson SF, Geschwind DH, Abrahams BS, Volkmar F, Pericak-Vance MA, Cuccaro ML, Gilbert J, Cook EH, Guter SJ, Jacob S, Nurnberger Jr JI, McDougle CJ, Posey DJ, Lord C, Corsello C, Hus V, Buxbaum JD, Kolevzon A, Soorya L, Parkhomenko E, Leventhal BL, Dawson G, Vieland VJ, Hakonarson H, Glessner JT, Kim C, Wang K, Schellenberg GD, Devlin B, Klei L, Minshew N, Sutcliffe JS, Haines JL, Lund SC, Thomson S, Yaspan BL, Coon H, Miller J, McMahon WM, Munson J, Estes A, Wijsman EM.  Gene-ontology enrichment analysis in two independent family-based samples highlights biologically plausible processes for autism spectrum disorders.  Eur J Hum Genet. (2011) Oct;19(10):1082-9.

Casey JP, Magalhaes T, Conroy JM, Regan R, Shah N, Anney R, Shields DC, Abrahams BS, Almeida J, Bacchelli E, Bailey AJ, Baird G, Battaglia A, Berney T, Bolshakova N, Bolton PF, Bourgeron T, Brennan S, Cali P, Correia C, Corsello C, Coutanche M, Dawson G, de Jonge M, Delorme R, Duketis E, Duque F, Estes A, Farrar P, Fernandez BA, Folstein SE, Foley S, Fombonne E, Freitag CM, Gilbert J, Gillberg C, Glessner JT, Green J, Guter SJ, Hakonarson H, Holt R, Hughes G, Hus V, Igliozzi R, Kim C, Klauck SM, Kolevzon A, Lamb JA, Leboyer M, Le Couteur A, Leventhal BL, Lord C, Lund SC, Maestrini E, Mantoulan C, Marshall CR, McConachie  H, McDougle CJ, McGrath J, McMahon WM, Merikangas A, Miller J, Minopoli F, Mirza GK, Munson J, Nelson SF, Nygren G, Oliveira G, Pagnamenta AT, Papanikolaou K, Parr JR, Parrini B, Pickles A, Pinto D, Piven J, Posey DJ, Poustka A, Poustka F,  Ragoussis J, Roge B, Rutter ML, Sequeira AF, Soorya L, Sousa I, Sykes N, Stoppioni V, Tancredi R, Tauber M, Thompson AP, Thomson S, Tsiantis J, Van Engeland H, Vincent JB, Volkmar F, Vorstman JA, Wallace S, Wang K, Wassink TH, White K, Wing K, Wittemeyer K, Yaspan BL, Zwaigenbaum L, Betancur C, Buxbaum JD,  Cantor RM, Cook EH, Coon H, Cuccaro ML, Geschwind DH, Haines JL, Hallmayer J, Monaco AP, Nurnberger JI Jr, Pericak-Vance MA, Schellenberg GD, Scherer SW, Sutcliffe JS, Szatmari P, Vieland VJ, Wijsman EM, Green A, Gill M, Gallagher L, Vicente A, Ennis S. A novel approach of homozygous haplotype sharing identifies candidate genes in autism spectrum disorder. Hum Genet. 2012 Apr;131(4):565-79. Epub 2011 Oct 14.

Maestrini E, Pagnamenta AT, Lamb JA, Bacchelli E, Sykes NH, Sousa I, Toma C, Barnby G, Butler H, Winchester L,  Scerri TS, Minopoli F, Reichert J, Cai G, Buxbaum JD, Korvatska O, Schellenberg GD, Dawson G, Bildt AD, Minderaa RB, Mulder EJ, Morris AP, Bailey AJ, Monaco AP. High-density SNP association study and copy number variation analysis of the AUTS1 and AUTS5 loci implicate the IMMP2L-DOCK4 gene region in autism susceptibility. Mol Psychiatry. (2010) 15Falter CM, Bailey AJ. Perception of Mirror Symmetry in Autism Spectrum Disorders. Autism. (2011) May 24. [Epub ahead of print(9):954-68.

Friedlander R. (2010). Early Onset Psychosis in Youth with Intellectual Disabilities. In Contemporary Issues in Intellectual Disabilities Ed. Vee Prasher. Nova Publishing, New York.

Sousa I, Clark TG, Holt R, Pagnamenta AT, Mulder EJ, Minderaa RB, Bailey AJ, Battaglia A, Klauck SM, Poustka F, Monaco AP; International Molecular Genetic Study of Autism Consortium (IMGSAC). Polymorphisms in leucine-rich repeat genes are associated with autism spectrum disorder susceptibility in populations of European ancestry.  Mol Autism. (2010) 1(1):7.

Wallace S, Parsons S, Westbury A, White K, Bailey A. Sense of presence and atypical social judgments in immersive virtual environments: Responses of adolescents with Autism Spectrum Disorders. Autism. (2010) 14:199-213.

Holt R, Barnby G, Maestrini E, Bacchelli E, Brocklebank D, Sousa I, Mulder EJ, Kantojärvi K, Järvelä I, Klauck SM, Poustka F, Bailey AJ, Monaco AP. Linkage and candidate gene studies of autism spectrum disorders in European populations. Eur J Hum Genet. (2010) 18:1013-9

Pinto D, Pagnamenta AT, Klei L, Anney R, Merico D, Regan R, Conroy J, Magalhaes TR, Correia C, Abrahams BS, Almeida J, Bacchelli E, Bader GD, Bailey AJ, Baird G, Battaglia A, Berney T, Bolshakova N, Bölte S, Bolton PF, Bourgeron T, Brennan S, Brian J, Bryson SE, Carson AR, Casallo G, Casey J, Chung BH, Cochrane L, Corsello C, Crawford EL, Crossett A, Cytrynbaum C, Dawson G, de Jonge M, Delorme R, Drmic I, Duketis E, Duque F, Estes A, Farrar P, Fernandez BA, Folstein SE, Fombonne E, Freitag CM, Gilbert J, Gillberg C, Glessner JT, Goldberg J, Green A, Green J, Guter SJ, Hakonarson H, Heron EA, Hill M, Holt R, Howe JL, Hughes G, Hus V, Igliozzi R, Kim C, Klauck SM, Kolevzon A, Korvatska O, Kustanovich V, Lajonchere CM, Lamb JA, Laskawiec M, Leboyer M, Le Couteur A, Leventhal BL, Lionel AC, Liu XQ, Lord C, Lotspeich L, Lund SC, Maestrini E, Mahoney W, Mantoulan C, Marshall CR, McConachie H, McDougle CJ, McGrath J, McMahon WM, Merikangas A, Migita O, Minshew NJ, Mirza GK, Munson J, Nelson SF, Noakes C, Noor A, Nygren G, Oliveira G, Papanikolaou K, Parr JR, Parrini B, Paton T, Pickles A, Pilorge M, Piven J, Ponting CP, Posey DJ, Poustka A, Poustka F, Prasad A, Ragoussis J, Renshaw K, Rickaby J, Roberts W, Roeder K, Roge B, Rutter ML, Bierut LJ, Rice JP, Salt J, Sansom K, Sato D, Segurado R, Sequeira AF, Senman L, Shah N, Sheffield VC, Soorya L, Sousa I, Stein O, Sykes N, Stoppioni V, Strawbridge C, Tancredi R, Tansey K, Thiruvahindrapduram B, Thompson AP, Thomson S, Tryfon A, Tsiantis J, Van Engeland H, Vincent JB, Volkmar F, Wallace S, Wang K, Wang Z, Wassink TH, Webber C, Weksberg R, Wing K, Wittemeyer K, Wood S, Wu J, Yaspan BL, Zurawiecki D, Zwaigenbaum L, Buxbaum JD, Cantor RM, Cook EH, Coon H, Cuccaro ML, Devlin B, Ennis S, Gallagher L, Geschwind DH, Gill M, Haines JL, Hallmayer J, Miller J, Monaco AP, Nurnberger JI Jr, Paterson AD, Pericak-Vance MA, Schellenberg GD, Szatmari P, Vicente AM, Vieland VJ, Wijsman EM, Scherer SW, Sutcliffe JS, Betancur C. Functional impact of global rare copy number variation in autism spectrum disorders.  Nature. (2010) 15;466(7304):368-72.

Pagnamenta AT, Bacchelli E, de Jonge MV, Mirza G, Scerri TS, Minopoli F, Chiocchetti A, Ludwig KU, Hoffmann P, Paracchini S, Lowy E, Harold DH, Chapman JA, Klauck SM, Poustka F, Houben RH, Staal WG, Ophoff RA, O’Donovan MC, Williams J, Nöthen MM, Schulte-Körne G, Deloukas P, Ragoussis J, Bailey AJ, Maestrini E, Monaco AP; International Molecular Genetic Study Of Autism Consortium.  Characterization of a family with rare deletions in CNTNAP5 and DOCK4 suggests novel risk loci for autism and dyslexia. Biol Psychiatry. 2010 68(4):320-8.

Anney R, Klei L, Pinto D, Regan R, Conroy J, Magalhaes TR, Correia C, Abrahams BS, Sykes N, Pagnamenta AT, Almeida J, Bacchelli E, Bailey AJ, Baird G, Battaglia A, Berney T, Bolshakova N, Bölte S, Bolton PF, Bourgeron T, Brennan S, Brian J, Carson AR, Casallo G, Casey J, Chu S, Cochrane L, Corsello C, Crawford EL, Crossett A, Dawson G, de Jonge M, Delorme R, Drmic I, Duketis E, Duque F, Estes A, Farrar P, Fernandez BA, Folstein SE, Fombonne E, Freitag CM, Gilbert J, Gillberg C, Glessner JT, Goldberg J, Green A, Green J, Guter SJ, Hakonarson H, Heron EA, Hill M, Holt R, Howe JL, Hughes G, Hus V, Igliozzi R, Kim C, Klauck SM, Kolevzon A, Korvatska O, Kustanovich V, Lajonchere CM, Lamb JA, Laskawiec M, Leboyer M, Le Couteur A, Leventhal BL, Lionel AC, Liu XQ, Lord C, Lotspeich L, Lund SC, Maestrini E, Mahoney W, Mantoulan C, Marshall CR, McConachie H, McDougle CJ, McGrath J, McMahon WM, Melhem NM, Merikangas A, Migita O, Minshew NJ, Mirza GK, Munson J, Nelson SF, Noakes C, Noor A, Nygren G, Oliveira G, Papanikolaou K, Parr JR, Parrini B, Paton T, Pickles A, Piven J, Posey DJ, Poustka A, Poustka F, Prasad A, Ragoussis J, Renshaw K, Rickaby J, Roberts W, Roeder K, Roge B, Rutter ML, Bierut LJ, Rice JP, Salt J, Sansom K, Sato D, Segurado R, Senman L, Shah N, Sheffield VC, Soorya L, Sousa I, Stoppioni V, Strawbridge C, Tancredi R, Tansey K, Thiruvahindrapduram B, Thompson AP, Thomson S, Tryfon A, Tsiantis J, Van Engeland H, Vincent JB, Volkmar F, Wallace S, Wang K, Wang Z, Wassink TH, Wing K, Wittemeyer K, Wood S, Yaspan BL, Zurawiecki D, Zwaigenbaum L, Betancur C, Buxbaum JD, Cantor RM, Cook EH, Coon H, Cuccaro ML, Gallagher L, Geschwind DH, Gill M, Haines JL, Miller J, Monaco AP, Nurnberger JI Jr, Paterson AD, Pericak-Vance MA, Schellenberg GD, Scherer SW, Sutcliffe JS, Szatmari P, Vicente AM, Vieland VJ, Wijsman EM, Devlin B, Ennis S, Hallmayer J. A genomewide scan for common alleles affecting risk for autism. Hum Mol Genet. (2010) 15;19(20):4072-82

Simon Wallace, Catherine Sebastian, Elizabeth Pellicano, Jeremy Parr and Anthony Bailey. Face processing abilities in relatives of individuals with ASD.  Autism Res. (2010) 3(6):345-9.

Du Souich C., Chou A., Yin J., Friedlander R., et al (2009). Characterization of a New A-Linked Mental Retardation Syndrome with Microcephaly, Cortical Malformation and Thin Habitus. AmJ Med Genet Part A 149A: 2469 – 2478.

Friedlander R., Moss, S. (2009). Mental Health Assessment of children and adolescents with Learning Disabilities. Journal of Public Mental Health, 8 ( 1) March 2009, pp 37 -45.

Du Souich C., Austin J.C., Friedlander R., Boerkoel N. (2009). A Novel syndrome with Psychiatric Features and Review of Malformation Syndromes with Psychiatric Disorders. American Journal of Medical Genetics Part A 149A: 713-721.

Dr. Robin Friedlander

email: rfriedlander@cw.bc.ca