Autism and autistic behavior in Joubert syndrome

To determine whether individuals with Joubert syndrome exhibit features of autism as defined by the Diagnostic and Statistical Manual of Mental Disord ers-IV (DSM-IV), we examined 11 children with Joubert syndrome using the Au tism Diagnostic Interview-Revised and the Autism Diagnostic Observation Sch edule-Generic. Three children met DSM-IV criteria for autistic disorder and one for pervasive developmental disorder not otherwise specified. The othe r seven all demonstrated at least one DSM-IV symptom of autism, but did not meet criteria for a pervasive developmental disorder. Both total number of DSM-IV symptoms and number of social symptoms distinguished the autism and nonautism subgroups. In contrast, the two subgroups displayed similar leve ls of communication impairments and repetitive or stereotyped behavior: The key to diagnosing autism in Joubert syndrome is to focus on social behavio rs, particularly milestones typically achieved very early in life (eg, atte nding to human voices, showing objects of interest, enjoyment of social int eractions). Implications for the role of the cerebellum in nonmotor behavio r and for clinical management of Joubert syndrome also are discussed.