Neuroleptic-related dyskinesias and stereotypies in autistic children: videotaped ratings

Tardive dyskinesia, an involuntary abnormal movement disorder, is a serious untoward effect of neuroleptic treatment. Certain patient populations likely to be treated with neuroleptics have an increased rate of abnormal movements--or stereotypies (ST)--at baseline that may be difficult to differentiate from neuroleptic-related dyskinesias. The objective of the present study was to ascertain whether blind raters could differentiate dyskinesias from ST on videotapes of autistic children and to compare ratings on the Abnormal Involuntary Movement Scale (AIMS) of patients seen live with ratings of patients seen on videotapes. Blind raters of videotapes could only differentiate dyskinesias from ST 59.3 percent of the time. Mean AIMS scores were higher for children with dyskinesias than for children with ST. A discriminant function based on AIMS Items 1 (muscles of facial expression), 2 (lips and perioral area), 6 (lower extremities), and 7 (neck, shoulders, hips) correctly classified all 9 children with dyskinesias and 8 of the 9 children with ST.