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.

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Available from: Andrew Pickles, Nov 18, 2015
    • "The aim of several studies has been to determine whether epileptiform abnormalities, not necessarily presenting as obvious seizures, nor presenting with syndromes such as the Landau–Kleffner syndrome, might be responsible for the " autistic regression " that occurs in approximately a third of children with (narrowly defined) autism under 36 months of age [8]. The results of these studies are conflicting and inconclusive. "
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    ABSTRACT: The controversies that have arisen in endeavoring to establish the nature of the relationships between autism and epilepsy might be summarized in a few simple questions, most of which do not yet have clear, complete answers. Does epilepsy cause autism? Does autism cause epilepsy? Are there underlying brain mechanisms that predispose to both conditions? What is the role of genetics in this regard? What is the importance of prenatal, perinatal, and postnatal environmental factors? Do any of the proposed relationships between autism and epilepsy provide insight into useful management or treatment? Is the prognosis of either autism or epilepsy different when the other condition is also present? What is the role of additional comorbidities, such as intellectual impairment or attention deficit hyperactivity disorder, in the relationship between the two conditions and in influencing treatment choices? From the evidence currently available, it would appear that epilepsy can rarely be the cause of autistic features but is not the cause of autism in most cases. There is currently no credible mechanism for suggesting that autism might cause epilepsy. There is strong evidence for an underlying predisposition for both conditions, particularly arising from genetic investigations. However, many issues remain unresolved. Considering the amount of research that has been published in this area, it is surprising that so few definitive answers have been established. The papers in this issue's special section provide additional insights into the relationships between autism and epilepsy; while they do not provide answers to all the questions, they represent considerable progress in this area and, at the very least, give some strong indication of what research might, in the future, provide such answers. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · Jun 2015 · Epilepsy & Behavior
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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.
    Full-text · Article · Nov 2014 · Epilepsy & Behavior
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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.
    Full-text · Article · Oct 2014 · Journal of Autism and Developmental Disorders
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