Journal of Autism and Developmental Disorders

, Volume 40, Issue 11, pp 1389–1402 | Cite as

Onset Patterns Prior to 36 Months in Autism Spectrum Disorders

  • Luther G. Kalb
  • J. K. Law
  • Rebecca Landa
  • Paul A. Law
Original Paper


The present study investigated differences among children with three different patterns of autism symptom onset: regression, plateau, and no loss and no plateau. Cross-sectional data were collected from parents of children aged 3–17 years with an autism spectrum disorder (n = 2,720) who were recruited through a US-based online research database. Parental report of developmental characteristics was assessed through a parent questionnaire, and current autism symptoms were measured via the Social Responsiveness Scale and Social Communication Questionnaire. Multivariate analyses indicated that children with regression had a distinct developmental pattern marked by less delayed early development. However, following regression, these children evinced elevated autism symptom scores and an increased risk for poorer outcomes when compared with the other onset groups.


Autism Pervasive developmental disorders Regression Symptom Onset pattern 



This research was supported by grants to the last author from Autism Speaks. The funder had no role in determining content. We would like to thank Connie Anderson, Teresa Foden, and Gregory Kalb for their unique contributions to this article.


  1. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: American Psychiatric Association.Google Scholar
  2. Bernabei, P., Cerquiglini, A., Cortesi, F., & D’Ardia, C. (2007). Regression versus no regression in the autistic disorder: Developmental trajectories. Journal of Autism and Developmental Disorders, 37, 580–588.CrossRefPubMedGoogle Scholar
  3. Berument, S. K., Rutter, M., Lord, C., Pickles, A., & Bailey, A. (1999). Autism Screening Questionnaire: Diagnostic validity. The British Journal of Psychiatry, 175, 444–451.CrossRefPubMedGoogle Scholar
  4. Chakrabari, S., & Fombonne, E. (2001). Pervasive developmental disorders in preschool children. The Journal of the American Medical Association, 285, 3093–3099.CrossRefGoogle Scholar
  5. Constantino, J., Davis, S., Todd, R., Schindler, M., Gross, M., Brophy, S., et al. (2003). Validation of a brief quantitative measure of autistic traits: Comparison of the Social Responsiveness Scale with the Autism Diagnostic Interview-Revised. Journal of Autism and Developmental Disorders, 33, 427–433.CrossRefPubMedGoogle Scholar
  6. 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.CrossRefPubMedGoogle Scholar
  7. Goldberg, W. A., Osann, K., Filipek, P. A., Laulhere, T., Jarvis, K., Modahl, C., et al. (2003). Language and other regression: Assessment and timing. Journal of Autism and Developmental Disorders, 33, 607–616.CrossRefPubMedGoogle Scholar
  8. Hansen, R. L., Ozonoff, S., Krakowiak, P., Angkustsiri, K., Jones, C., et al. (2009). Regression in autism: Prevalence and associated factors in the CHARGE study. Ambulatory Pediatrics, 8, 25–31.CrossRefGoogle Scholar
  9. Hoshino, Y., Kaneko, M., Yashima, Y., Kumashiro, H., Volkmar, F., & Cohen, D. (1987). Clinical features of autistic children with setback course in their infancy. Japanese Journal of Child and Adolescent Psychiatry, 26, 201–212.Google Scholar
  10. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.Google Scholar
  11. Kobayashi, R., & Murata, T. (1998). Setback phenomenon in autism and long term prognosis. Acta Psychiatrica Scandinavia, 98, 296–303.CrossRefGoogle Scholar
  12. Kurita, H. (1985). Infantile autism with speech loss before the age of thirty months. Journal of the American Academy of Child and Adolescent Psychiatry, 24, 191–196.CrossRefGoogle Scholar
  13. Kurita, H., Kita, M., & Miyake, Y. (1992). A comparative study of development and symptoms among disintegrative psychosis and infantile autism with and without speech loss. Journal of Autism and Developmental Disorders, 22, 175–188.CrossRefPubMedGoogle Scholar
  14. Landa, R. J. (2008). Diagnosis of autism spectrum disorders in the first 3 years of life. Nature Clinical Practice Neurology, 4, 138–147.CrossRefPubMedGoogle Scholar
  15. Landa, R. J., Holman, K. C., & Garrett-Mayer, E. (2007). Social and communication development in toddlers with early and later diagnosis of autism spectrum disorders. Archives of General Psychiatry, 64, 853–864.CrossRefPubMedGoogle Scholar
  16. Lord, C., Shulman, C., & DiLavore, P. (2004). Regression and word loss in autistic spectrum disorders. Journal of Child Psychology and Psychiatry and Allied Disciplines, 45, 936–955.CrossRefGoogle Scholar
  17. Luyster, R., Richler, J., Risi, S., Hsu, W. L., Dawson, G., Bernier, R., et al. (2005). Early regression in social communication in autism spectrum disorders: A CPEA study. Developmental Neuropsychology, 27, 311–336.CrossRefPubMedGoogle Scholar
  18. Ozonoff, S., Heung, K., Byrd, R., Hansen, R., & Hertz-Picciotto, I. (2008). The onset of autism: Patterns of symptom emergence in the first years of life. Autism Research, 1, 320–328.CrossRefPubMedGoogle Scholar
  19. Pine, E., Luby, J., Abbacchi, A., & Constantino, J. N. (2006). Quantitative assessment of autistic symptomatology in preschoolers. Autism: The International Journal of Research and Practice, 10, 344–352.Google Scholar
  20. Rogers, S. J. (2004). Developmental regression in autism spectrum disorders. Journal of Mental Retardation and Developmental Disabilities Research, 10, 139–143.CrossRefGoogle Scholar
  21. Rogers, S. J., & 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.CrossRefPubMedGoogle Scholar
  22. Short, A. B., & Schopler, E. (1988). Factors relating to age of onset in autism. Journal of Autism and Developmental Disorders, 18, 207–215.CrossRefPubMedGoogle Scholar
  23. Siperstein, R., & Volkmar, F. (2004). Brief report: Parental reporting of regression in children with pervasive developmental disorders. Journal of Autism and Developmental Disorders, 34, 731–734.CrossRefPubMedGoogle Scholar
  24. Volkmar, F. R., & Cohen, D. J. (1989). Disintegrative disorder or “late onset” autism. Journal of Child Psychiatry and Psychology, 30, 717–724.CrossRefGoogle Scholar
  25. Volkmar, F. R., Stier, D. M., & Cohen, D. J. (1985). Age of recognition of pervasive developmental disorder. American Journal of Psychiatry, 142, 1450–1452.PubMedGoogle Scholar
  26. Werner, E., Dawson, G., Munson, J., & Osterling, J. (2005). Variation in early developmental course in autism and its relation with behavioral outcome at 3–4 years of age. Journal of Autism and Developmental Disorders, 35, 337–350.CrossRefPubMedGoogle Scholar
  27. Wilson, S., Djukic, A., Shinnar, S., Dharmani, C., & Rapin, I. (2003). Clinical characteristics of language regression in children. Developmental Medicine and Child Neurology, 45, 508–514.CrossRefPubMedGoogle Scholar
  28. World Health Organization (1992). International classification of disease-10, Geneva.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Luther G. Kalb
    • 1
  • J. K. Law
    • 2
    • 3
  • Rebecca Landa
    • 1
    • 4
  • Paul A. Law
    • 2
    • 3
  1. 1.Center for Autism and Related DisordersKennedy Krieger InstituteBaltimoreUSA
  2. 2.Department of Medical InformaticsKennedy Krieger InstituteBaltimoreUSA
  3. 3.Department of PediatricsThe Johns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Department of Psychiatry and Behavioral SciencesThe Johns Hopkins University School of MedicineBaltimoreUSA

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