title: Cognitive and behavioral characterization of 16p11.2 deletion syndrome.
abstract: OBJECTIVE
  To describe cognitive and behavioral features of patients with chromosome 16p11.2 deletion syndrome, a recently identified and common genetic cause of neurodevelopmental disability, especially autism spectrum disorder (ASD).
  
  
  METHODS
  Twenty-one patients with 16p11.2 deletion were evaluated by medical record review. A subset of 11 patients consented to detailed cognitive, behavioral, and autism diagnostic assessment.
  
  
  RESULTS
  Patients with 16p11.2 deletion had varying levels of intellectual disability, variable adaptive skills, and a high incidence of language delay. Attention issues were not as frequent as had been reported in previous clinical reports. Atypical language, reduced social skills, and maladaptive behaviors were common, as was diagnosis of ASD. Based on medical record review, 7 of 21 patients (33%) had an ASD diagnosis. Among patients receiving detailed phenotyping, 3 of 11 (27%) met full criteria (met cutoff scores on both Autism Diagnostic Observation Schedule and Autism Diagnostic Interview) for an ASD diagnosis, whereas 6 other patients (55%) met criteria for ASD on either the Autism Diagnostic Observation Schedule or the Autism Diagnostic Interview, but not both measures.
  
  
  CONCLUSIONS
  Rates of ASD were similar to previous reports that are based on medical record reviews, but formal assessment revealed that a majority of patients with 16p11.2 deletion demonstrate features of ASD beyond simple language impairment. All patients with 16p11.2 deletion should receive formal neurodevelopmental evaluation including measures to specifically assess cognitive, adaptive, language, and psychiatric/behavioral issues. Clinical evaluation of this patient population should always include assessment by Autism Diagnostic Interview and Autism Diagnostic Observation Schedule to detect behaviors related to ASD and possible ASD diagnosis.
authors.affiliation: Division of Developmental Medicine, Children's Hospital Boston, Boston, MA 02115, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Hanson
authors.forename: Ramzi H
authors.initials: RH
authors.lastname: Nasir
authors.forename: Alexa
authors.initials: A
authors.lastname: Fong
authors.forename: Alyss
authors.initials: A
authors.lastname: Lian
authors.forename: Rachel
authors.initials: R
authors.lastname: Hundley
authors.forename: Yiping
authors.initials: Y
authors.lastname: Shen
authors.forename: Bai-Lin
authors.initials: BL
authors.lastname: Wu
authors.forename: Ingrid A
authors.initials: IA
authors.lastname: Holm
authors.forename: David T
authors.initials: DT
authors.lastname: Miller
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001321:Autistic Disorder / Q000235:genetics; D001900:Boston / Q000453:epidemiology; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology; D002675:Child, Preschool; D002872:Chromosome Deletion; D002885:Chromosomes, Human, Pair 16 / Q000235:genetics*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology; D007805:Language Development Disorders / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D010641:Phenotype; D012720:Severity of Illness Index; D012919:Social Behavior; D013577:Syndrome