Abstract
Understanding of regression in autism has been hampered by variability in parental and clinical recognition and reporting of lost skills. This study introduced an instrument, the Regression Supplement Form, intended to supplement the Autism Diagnosis Interview–Revised and yield precise information about the types and timing of regression and events concurrent with loss and regain of skills. Data were collected from parents of 44 children (38 male, 6 female; mean age = 6 years) with Autistic Spectrum Disorder (37 Autistic Disorder, 7 Pervasive Developmental Disorder–Not Otherwise Specified). Parental responses on the Autism Diagnosis Interview–Revised indicated loss of skills during early development. The profile of regression that emerged included loss of skills between 18 and 21 months, on average, with language-only regression less common than loss of other, nonlanguage skills only or of full regression (loss of language and other skills). The onset of regression typically was gradual in nonlanguage areas and split between gradual and sudden loss for language skills. Some of the children were developing atypically before they lost other, nonlanguage skills, that is, their age at first words was delayed until age 2 years or older. Parents tended to attribute loss to medical factors such as immunizations. Many of the children regained some of the lost skills when they were 3.5–5 years of age, with therapeutic and instructional interventions given credit for the regain.
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References
American Academy of Neurology (2000). Practice parameter: Screening and diagnosis of autistic spectrum disorders (A multi-society consensus statement). Neurology, 55, 468-479.
American Academy of Pediatrics (2001). Technical report: The pediatrician's role in the diagnosis and management of autistic spectrum disorder. Committee on Children with Disabilities. Pediatrics, 107, E85.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Baranek, G. T. (2002). Efficacy of sensory and motor interventions for children with autism. Journal of Autism and Developmental Disorders, 32, 397-422.
Bayley, N. (1993). Bayley Scales of Infant Development (BSID-II) (2nd ed.). New York: The Psychological Corporation.
Bristol, M. P., Cohen, D. J., Costello, E. J., Denckla, M., Eckberg, T. J., Kallen, R., Kraemer, H. C., Lord, C., Mauerer, R., McIlvane, W. J., Minshew, N., Sigman, M., & Spence, M. A. (1996). State of the science in autism: Report to the National Institutes of Health. Journal of Autism and Developmental Disorders, 26, 121-154.
Bristol-Power, M. M., & Spinella, G. (1999). Research on screening and diagnosis in autism: A work in progress. Journal of Autism and Developmental Disorders, 29, 435-438.
Cooper, J., Kim, P. Y., Taylor, A., & Lord, C. (2001). Early communication and social skills in children with autistic spectrum disorders, with and without early word loss. Poster presented at the International Meeting for Autism Research, San Diego, CA, November.
Davidovitch, M., Glick, L., Holtzman, G., Tirosh, E., & Safir, M. P. (2000). Developmental regression in autism: Maternal perception. Journal of Autism and Developmental Disorders, 30, 113-119.
De Giacomo, A., & Fombonne, E. (1998). Parental recognition of developmental abnormalities in autism. European Child and Adolescent Psychiatry, 7, 131-136.
Filipek, P. A., Accardo, P. J., Baranek, G. T., Cook Jr, E. H., Dawson, G., Gordon, B., Gravel, J. S., Johnson, C. P., Kallan, R. J., Levy, S. E., Minshew, N. J., Ozonoff, S., Prizant, B. M., Rapin, I., Rogers, S. J., Stone, W. L., Teplin, S., Tuchman, R. F., & Volkmar, F. R. (1999). The screening and diagnosis of autistic spectrum disorders. Journal of Autism and Developmental Disorders, 29, 437-482.
Hollingshead, A. B. (1975). Four factor model of social status. New Haven, CT: Yale University, Department of Sociology.
Hoshino, Y., Kaneko, M., Yashima, Y., Kumashiro, H., Volkmar, F. R., & Cohen, D. J. (1987). Clinical features of autistic children with setback course in their infancy. Japanese Journal of Psychiatry and Neurology, 41, 237-245.
Kurita, H. (1985). Infantile autism with speech loss before the age of 30 months. Journal of the American Academy of Child Psychiatry, 24, 191-196.
Kurita, H. (1996). Specificity and developmental consequences of speech loss in children with pervasive developmental disorders. Psychiatry and Clinical Neurosciences, 50, 181-184.
Le Couteur, A., Rutter, M., Lord, C., Rios, P., Robertson, S., Holdgrafer, M., & McLennan, J. D. (1989). Autism Diagnostic Interview: A semi-structured interview for the parents and caregivers of autistic persons. Journal of Autism and Developmental Disorders, 19, 363-387.
Lord, C. (1995). Follow-up of two-year-olds referred for possible autism. Journal of Child Psychology and Psychiatry, 36, 1365-1382.
Lord, C., Pickles, A., McLennan, J., Rutter, M., Bregman, J., Folstein, S., Fombonne, E., Leboyer, M., & Minshew, N. (1997). Diagnosing autism: Analyses of data from the Autism Diagnostic Interview. Journal of Autism and Developmental Disorders, 27, 501-517.
Lord, C., Rutter, M., Goode, S., Heemsbergen, J., Jordan, H., Mawhood, L., & Schopler, E. (1989). Autism Diagnostic Observation Schedule: A standardized observation of communicative and social behavior. Journal of Autism and Developmental Disorders, 19, 185-212.
Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview–Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders 24, 659-685.
Lord, C., Storoschuk, S., Rutter, M., & Pickles, A. (1993). Using the ADI-R to diagnose autism in preschool children. Infant Mental Health Journal, 14, 234-252.
Mullen, E. M. (1995). Mullen Scales of Early Learning: AGS edition. Circle Pines, MN: American Guidance Service.
Mundy, P. (1995). Joint attention and social-emotional approach behavior in children with autism. Development and Psychopathology, 7, 63-82.
Rapin, I., & Katzman, R. (1998). Neurobiology of autism. Annals of Neurology, 43, 7-14.
Rogers, S., & DiLalla, D. (1990). Age of symptom onset in young children with pervasive developmental disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 863-872.
Rutter, M., & Lord, C. (1987). Language disorders associated with psychiatric disturbances. In W. Yule & M. Rutter (Eds.), Language development and disorders (pp. 206-233). Philadelphia: Lippincott.
Shinnar, S., Rapin, I., Arnold, S., Tuchman, R. F., Shulman, L., Ballaban-Gil, K., Maw, M., Deuel, R. K., & Volkmar, F. R. (2001). Language regression in childhood. Pediatric Neurology, 24, 183-189.
Short, A., & Schopler, E. (1988). Factors relating to age of onset in autism. Journal of Autism and Developmental Disorders, 18, 207-216.
Shulman, C., Lord, C., & DiLavore, P. C. (1996). Relationship between early loss of language skills and later development in autism. Paper presented at the meeting of the International Society for the Study of Behavior Development, Quebec City, Quebec, August.
Siegel, B. (1996). The world of the autistic child: Understanding and treating autistic spectrum disorders. New York: Oxford University Press.
Thorndike, R. L., Hagen, E. P., & Satttler, J. M. (1986). The Stanford-Binet Intelligence Scale: Fourth Edition. Guide for Administration and Scoring. Chicago: Riverside Publishing Company.
Toth, K., Dawson, G., Munson, J., & Osterling, J. (2001). Defining the earliest social attention impairments in autism: Social orienting, joint attention, and responses to emotion. Poster presented at the biennial meeting of the Society for Research in Child Development, Indianapolis, IN, April.
Tuchman, R. F. (1996). Pervasive developmental disorders: Neurological perspectives. Revista de Neuologia, 24, 1446-1550.
Tuchman, R. F., & Rapin, I. (1997). Regression in pervasive developmental disorders: Seizures and epileptiform electroencephalogram correlates. Pediatrics, 99, 560-566.
Volkmar, F. R., Stier, D. M., & Cohen, D. J. (1985). Age of recognition of pervasive developmental disorder. American Journal of Psychiatry, 142, 1450-1452.
Wakefield, A. J., Murch, S. H., Anthony, A., Linnell, J., Casson, D. M., Malik, M., Berelowitz, M., Dhillon, A. P., Thomson, M. A., Harvey, P., Valentine, A., Davies, S. E., Walker-Smith, J. A. (1998). Ileal-lymphoid-modular hyperplasia non-specific colitis, and pervasive developmental disorder in children. Lancet, 351, 637-641.
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Goldberg, W.A., Osann, K., Filipek, P.A. et al. Language and Other Regression: Assessment and Timing. J Autism Dev Disord 33, 607–616 (2003). https://doi.org/10.1023/B:JADD.0000005998.47370.ef
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DOI: https://doi.org/10.1023/B:JADD.0000005998.47370.ef