Regression, Developmental Trajectory and Associated Problems in Disorders in the Autism Spectrum: The SNAP Study

Newcomen Centre, Guy's & St. Thomas' NHS Foundation Trust, London, SE1 9RT, UK.
Journal of Autism and Developmental Disorders (Impact Factor: 3.34). 06/2008; 38(10):1827-36. DOI: 10.1007/s10803-008-0571-9
Source: PubMed


We report rates of regression and associated findings in a population derived group of 255 children aged 9-14 years, participating in a prevalence study of autism spectrum disorders (ASD); 53 with narrowly defined autism, 105 with broader ASD and 97 with non-ASD neurodevelopmental problems, drawn from those with special educational needs within a population of 56,946 children. Language regression was reported in 30% with narrowly defined autism, 8% with broader ASD and less than 3% with developmental problems without ASD. A smaller group of children were identified who underwent a less clear setback. Regression was associated with higher rates of autistic symptoms and a deviation in developmental trajectory. Regression was not associated with epilepsy or gastrointestinal problems.

Download full-text


Available from: Andrew Pickles, Nov 18, 2015
  • Source
    • "Regression occurs in about one-quarter to one-third of cases [4] [5]. One of the hypotheses put forward is that epileptiform discharges, in the absence of obvious seizures, might play a role in developmental regression . "
    [Show abstract] [Hide abstract]
    ABSTRACT: This article is part of a Special 15th Anniversary Issue. Copyright © 2014 Elsevier Inc. All rights reserved.
    Epilepsy & Behavior 11/2014; 40:37-41. DOI:10.1016/j.yebeh.2014.10.007 · 2.26 Impact Factor
  • Source
    • "Regression is a relatively common phenomenon in many pediatric neurologic disorders and has been linked to genetic diagnoses (Miles 2011). Though several reports have suggested that the eventual outcome in children with regression is that of a lower language level, lower IQ and lower adaptive level compared with those who do not regress, other studies have found no difference in outcome (Baird et al. 2008). Baird et al. found children with broad ASD diagnoses showed greater symptom severity in the presence of some language regression versus no regression. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Varied cluster analysis were applied to facial surface measurements from 62 prepubertal boys with essential autism to determine whether facial morphology constitutes viable biomarker for delineation of discrete Autism Spectrum Disorders (ASD) subgroups. Earlier study indicated utility of facial morphology for autism subgrouping (Aldridge et al. in Mol Autism 2(1):15, 2011). Geodesic distances between standardized facial landmarks were measured from three-dimensional stereo-photogrammetric images. Subjects were evaluated for autism-related symptoms, neurologic, cognitive, familial, and phenotypic variants. The most compact cluster is clinically characterized by severe ASD, significant cognitive impairment and language regression. This verifies utility of facially-based ASD subtypes and validates Aldridge et al.'s severe ASD subgroup, notwithstanding different techniques. It suggests that language regression may define a unique ASD subgroup with potential etiologic differences.
    Journal of Autism and Developmental Disorders 10/2014; 45(5). DOI:10.1007/s10803-014-2290-8 · 3.34 Impact Factor
    • "Richler et al. (2006) studied 351 children with ASD at an average age of 9.6 years and found that those who experienced regression had poorer verbal IQ and social-reciprocity scores (per the ADI-R) but did not differ from the nonregression group in terms of nonverbal IQ, ADOS parameters, or adaptive functioning. Additionally, Baird et al. (2008) studied a large, population-derived sample of children with ASD and reported differences between children who regressed and those who did not in terms of ASD-symptom severity but not IQ, adaptive behaviors, or language acquisition. It is not clear why such discrepant findings have been observed across studies comparing outcomes between regression and non-regression groups. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Studies using varied methods report that developmental regression occurs in a sizeable proportion of children with autism spectrum disorder (ASD). Findings are equivocal as to whether regression is associated with poorer cognitive and adaptive functioning. This study examined retrospective parent report in 2105 Simons Simplex Collection participants with ASD. Children were classified as having “full” or “subthreshold” losses on language and/or other skills using items from the Autism Diagnostic Interview-Revised (ADI-R) and a supplemental interview to capture more subtle regressions. Overall, 36.9% of children had some type of regression (27.8% language, 27.0% other-skill loss), with the supplemental interview capturing 11.7% of losses that would have been missed using the ADI-R alone. This figure is consistent with previous parent-report studies but lower than clinician-observed rates in prospective investigations. Early language losses—either full or subthreshold—and full other-skill losses appear to be associated with more deleterious outcomes by middle childhood. Findings may signify the need for more immediate and/or intense therapies for children who have even minor skill losses, particularly in language skills. Results further demonstrate the utility of an expanded set of additional queries with slightly modified criteria to capture such early, subtle losses.
    Research in Autism Spectrum Disorders 07/2014; 8(7):890–898. DOI:10.1016/j.rasd.2014.04.002 · 2.96 Impact Factor
Show more