To the Editor.—

I fear that in our haste to identify new treatments for children with autism and other pervasive developmental disorders, researchers and clinicians have thrown the diagnostic infant out with the bathwater. The article “Risperidone in the Treatment of Disruptive Behavioral Symptoms in Children With Autistic and Other Pervasive Developmental Disorders,” published online by Pediatrics in November 2004, is a case in point.

The authors performed a randomized, double-blind, placebo-controlled study of the efficacy and safety of risperidone in the treatment of “disruptive behavioral symptoms in children with autism and other pervasive developmental disorders.” Although the authors used a behavioral checklist, no formal evaluation or diagnostic procedure was applied to determine if any of these children had undiagnosed medical conditions or met (modified or unmodified) diagnostic criteria for specific psychiatric disorders. The authors found that 87% of treated subjects showed global improvement in their condition compared...

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