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that is more protracted and not likely to include the same level of abstraction. Similar to children with speech language impairment (SLI), children with ASDs may perform poorly on nonword repetition (Kjelgaard & Tager-Flusberg, 2001). Communication de cits with ASDs differ from those of children with SLI (see 4) in that both verbal and nonverbal communication is affected (Whitehouse, Barry, & Bishop, 2007). SLI or level of language at age 6 to 8 years was found to account for the greatest variation in outcome in adolescents on the spectrum, with decreased language at age 6 or 8 predictive of outcome in adolescence (T. Bennett et al., 2008). This highlights the importance of language/communication not only during childhood but as individuals on the spectrum enter adulthood. Out of those children with autism who develop language, 25% of these children maintain a rudimentary stage of verbal and nonverbal language (Minshew, 1997). When communicating with others, children with autism may interrupt others frequently, have dif culty holding an extensive conversation with spontaneous dialogue, and have dif culty understanding satire, jokes, or nonliteral language (Happ , 1993; Whitman, 2004). Pragmatic communication is similarly impaired (Loth, G mez, & Happ , 2008). Nonverbal communication oftentimes follows a similar sequence as language with (a) initially no eye contact; (b) distant glancing that is constant; (c) the use of the glancing eye in social situations; (d) eye contact that is prolonged in social situations; and (e) engaging in eye contact in social situations that is normal in quantity (Minshew, 1997). Another component to nonverbal communication is facial expression. Facial expressions in children with autism typically are expressionless or consist of a smile that is unvarying (Minshew, 1997).



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Kuivenhoven, JA, et al, The Role of a Common Variant of the Cholesteryl Ester Transfer Protein Gene in the Progression of Coronary Atherosclerosis, N Engl J Med, 338, 86 93 (1998) Layton, MA, et al, The Therapeutic Response to D-Penicillamine in Rheumatoid Arthritis: In uence of Glutathione S-Transferase Polymorphisms, Rheumatology (Oxford), 38, 43 47 (1999) Lazarou, J, et al, Incidence of Adverse Drug Reactions in Hospitalized Patients: A Meta-Analysis of Prospective Studies, JAMA, 279, 1200 1205 (1998) Linder, MW, Genetic Mechanisms for Hypersensitivity and Resistance to the Anticoagulant Warfarin, Clin Chim Acta, 308, 9 15 (2001) Luzzatto, L, and A Mehta, Glucose 6-Phosphate Dehydrogenase De ciency, In: Scriver CR et al (eds), The Metabolic and Molecular Bases of Inherited Disease, 7th ed New York: McGraw-Hill (1995) Meyer, UA.

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If DES were labeled a defective product, the plaintiffs could have established a legal link between the product and the increased risk of cancer In rejecting the applicability of strict liability, the California court reduced the pharmaceutical company s legal duty to warn of the dangerous propensity of DES at the time of its manufacture (a negligence standard) Because the harm complained of was not apparent until the 1970s, it was impossible for the plaintiffs to prove that the manufacturer knew of the drug s risks in the 1950s, when the plaintiffs mothers ingested DES The California litigation, however, was only one of several cases involving DES led after a 1971 article described how a rare form of vaginal cancer in a 15-year-old was linked to her mother s ingestion of DES during pregnancy..

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, Pharmacogenetics and Adverse Drug Reactions, Lancet, 356, 1667 1671 (2000) Middeldorp, S, et al, A Prospective Study of Asymptomatic Carriers of the Factor V Leiden Mutation to Determine the Incidence of Venous Thromboembolism, Ann Intern Med, 135, 322 327 (2001) Nebert, DW, Polymorphisms in Drug-Metabolizing Enzymes: What is Their Clinical Relevance and Why Do They Exist , Am J Hum Genet, 60, 265 271 (1997) Phillips, KA, et al, Potential Role of Pharmacogenomics in Reducing Adverse Drug Reactions: A Systematic Review, JAMA, 286, 2270 2279 (2001) Poirier, J, et al, Apolipoprotein E4 Allele as a Predictor of Cholinergic De cits and Treatment Outcome in Alzheimer Disease, Proc Natl Acad Sci USA, 92, 12260 12264 (1995) Roses, AD, Pharmacogenetics and Future Drug Development and Delivery, Lancet, 355, 1358 1361 (2000a) Roses, AD.

3 5 12 12 T Score 45 35 41 35 35 40 35 45 40 45 50 40 55 Standard Score 127 96 109 95 97 99 116 112 91 (continued)

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