Regression in Autistic Spectrum Disorders
A significant proportion of children diagnosed with Autistic Spectrum Disorder experience a developmental regression characterized by a loss of previously-acquired skills. This may involve a loss of speech or social responsitivity. but often entails both. This paper critically reviews the phenomena of regression in autistic spectrum disorders, highlighting the characteristics of regression, age of onset, temporal course, and long-term outcome. Important considerations for diagnosis are discussed and multiple etiological factors Currently hypothesized to underlie the phenomenon are reviewed. It is argued that regressive autistic spectrum disorders can be conceptualized on a spectrum with other regressive disorders that may share common pathophysiological features. The implications of this viewpoint are discussed.
[Show abstract] [Hide abstract] ABSTRACT: We compared loss and gain in communication from 1 to 2 years in children later diagnosed with autism spectrum disorder (n = 41), language impairment (n = 110) and in children with typical language development at 7 years (n = 831). Participants were selected from a prospective population cohort study of child language (the Early Language in Victoria Study). Parent-completed communication tools were used. As a group, children with autism spectrum disorder demonstrated slower median skill gain, with an increasing gap between trajectories compared to children with typical development and language impairment. A proportion from all groups lost skills in at least one domain (autism spectrum disorder (41%), language impairment (30%), typical development (26%)), with more children with autism spectrum disorder losing skills in more than one domain (autism spectrum disorder (47%), language impairment (15%, p = 0.0003), typical development (16%, p < 0.001)). Loss was most common for all groups in the domain of ‘emotion and eye gaze’ but with a higher proportion for children with autism spectrum disorder (27%; language impairment (12%, p = 0.03), typical development (14%, p = 0.03)). A higher proportion of children with autism spectrum disorder also lost skills in gesture (p = 0.01), sounds (p = 0.009) and understanding (p = 0.004) compared to children with typical development but not with language impairment. These findings add to our understanding of early communication development and highlight that loss is not unique to autism spectrum disorder.0Comments 0Citations
- "Early onset ASD is the gradual unfolding of symptoms over the course of the first few years of life. Regressive onset is a pattern of normal or near normal development followed by an abrupt or gradual loss of skills (Stefanatos, 2008), primarily involving the loss of words and/or social communication skills (Lord et al., 2004). Approaches to defining and measuring regression are varied in the literature. "
[Show abstract] [Hide abstract] ABSTRACT: In recent years, many studies indicate that children with an autism spectrum disorder (ASD) diagnosis have brain pathology suggestive of ongoing neuroinflammation or encephalitis in different regions of their brains. Evidence of neuroinflammation or encephalitis in ASD includes: microglial and astrocytic activation, a unique and elevated proinflammatory profile of cytokines, and aberrant expression of nuclear factor kappa-light-chain-enhancer of activated B cells. A conservative estimate based on the research suggests that at least 69% of individuals with an ASD diagnosis have microglial activation or neuroinflammation. Encephalitis, which is defined as inflammation of the brain, is medical diagnosis code G04.90 in the International Classification of Disease, 10th revision; however, children with an ASD diagnosis are not generally assessed for a possible medical diagnosis of encephalitis. This is unfortunate because if a child with ASD has neuroinflammation, then treating the underlying brain inflammation could lead to improved outcomes. The purpose of this review of the literature is to examine the evidence of neuroinflammation/encephalitis in those with an ASD diagnosis and to address how a medical diagnosis of encephalitis, when appropriate, could benefit these children by driving more immediate and targeted treatments.1Comment 0Citations
- "Neuronal demyelination could also lead to neurological loss of skills and abilities and possibly characterize the regression scenario in ASD. The concept of regression (loss of previously acquired skills and abilities) in some children with ASD has been validated by many studies (Tuchman, 1996; Davidovitch et al., 2000; Goldberg et al., 2003; Ozonoff et al., 2005 Ozonoff et al., , 2010 Werner and Dawson, 2005; Hansen et al., 2008; Stefanatos, 2008; Malhi and Singhi, 2012; Kern et al., 2014a,b). For example, Werner and Dawson (2005) evaluated home videotapes of children with autism between their first and second birthday parties with and without a reported history of regression, as well as videotapes of typically developing children. "
- "Again, despite the controversy, no link has been found to vaccines [5,43]. It should be further noted that numerous studies are underway to investigate the possibility that regressive autism has an autoimmune basis . There have even been studies which indicate a significant association between advancing paternal age and ASD. "