Presence of autism, hyperserotonemia, and severe expressive language impairment in Williams-Beuren syndrome

Table 2 Autistic impairments and neurobehavioral characteristics

Characteristics	Patient 1	Patient 2
Autistic behavioral domains and autism diagnosis^a
ADI–R
Abnormalities of development evident at or before age 36 months (cutoff = 1)	5	4
Nonverbal communication (cutoff = 7)	14	12
Reciprocal social interaction (cutoff = 10)	26	23
Repetitive behaviors and stereotyped patterns (cutoff = 3)	9	9
ADOS (module 1)
Communication (cutoff = 4)	5	5
Reciprocal social interaction (cutoff = 7)	13	8
Communication + social interaction total (cutoff = 12)	18	13
Play	3	1
Repetitive behaviors and stereotyped patterns	5	4
Expressive behaviors
Verbal language	None (total absence of words)	None (total absence of words)
Self-injurious behaviors	Ear-slapping, hand-biting	Self-scratching until bleeding, elbow-banging

^aAccording to the ADI–R (parental interview) or the ADOS (direct observation of the patient) algorithm, the DSM-IV-TR and the ICD-10 diagnostic criteria for autistic disorder are fulfilled when the total scores of each domain reach the cutoff point.