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

ABSTRACT 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.

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    • "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 . "
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    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
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    • "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. "
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    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
    • "word stage, as loss of words or babble with regression of social and play skills [Baird et al., 2008]. Cases not meeting criteria for a diagnosis of ASD were categorized as SEN; these children had SEN and a variety of other diagnoses including attention deficit hyperactivity disorder, cerebral palsy, language disorders, and intellectual disability [Baird et al., 2008]. Cognitive function was established using the Wechsler Intelligence Scale for Children-III-UK (WISC) [Wechsler, 1992], Raven's Standard Progressive Matrices (SPM) [Raven, Court, & Raven, 1990a], or Coloured Progressive Matrices (CPM) [Raven, Court, & Raven, 1990b], depending on the child's ability. "
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    ABSTRACT: To test whether gut permeability is increased in autism spectrum disorders (ASD) by evaluating gut permeability in a population-derived cohort of children with ASD compared with age- and intelligence quotient-matched controls without ASD but with special educational needs (SEN). One hundred thirty-three children aged 10-14 years, 103 with ASD and 30 with SEN, were given an oral test dose of mannitol and lactulose and urine collected for 6 hr. Gut permeability was assessed by measuring the urine lactulose/mannitol (L/M) recovery ratio by electrospray mass spectrometry-mass spectrometry. The ASD group was subcategorized for comparison into those without (n = 83) and with (n = 20) regression. There was no significant difference in L/M recovery ratio (mean (95% confidence interval)) between the groups with ASD: 0.015 (0.013-0.018), and SEN: 0.014 (0.009-0.019), nor in lactulose, mannitol, or creatinine recovery. No significant differences were observed in any parameter for the regressed versus non-regressed ASD groups. Results were consistent with previously published normal ranges. Eleven children (9/103 = 8.7% ASD and 2/30 = 6.7% SEN) had L/M recovery ratio > 0.03 (the accepted normal range cut-off), of whom two (one ASD and one SEN) had more definitely pathological L/M recovery ratios > 0.04. There is no statistically significant group difference in small intestine permeability in a population cohort-derived group of children with ASD compared with a control group with SEN. Of the two children (one ASD and one SEN) with an L/M recovery ratio of > 0.04, one had undiagnosed asymptomatic celiac disease (ASD) and the other (SEN) past extensive surgery for gastroschisis. Autism Res 2013, ●●: ●●-●●. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.
    Autism Research 06/2014; 7(3). DOI:10.1002/aur.1350 · 4.33 Impact Factor
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