Original articleLanguage regression in childhood
Introduction
Language regression is generally the most salient feature of both autistic regression [1], [2], [3] and acquired epileptic aphasia (Landau-Kleffner syndrome) [4], [5], [6]. It is not a feature of developmental delay or developmental language disorders [7]. There are insufficient data on the frequency with which it occurs, the age distribution, and the associated clinical features and outcome. We have a longstanding interest in the occurrence of language regression and its potential relationship to epilepsy and epileptiform brain activity as recorded in electroencephalogram (EEG) studies. As part of a planned multicenter treatment trial of children with language regression, 177 children with this history were identified prospectively. This report describes the clinical characteristics of these children.
Section snippets
Methods and materials
During the period from January 1996 to January 1998, children with a history of language regression were identified prospectively at four major medical centers with varied referral patterns. The pediatric neurology division at Montefiore Medical Center and the Albert Einstein College of Medicine identified 32 subjects over a 1-year period. Dr. Rapin prospectively identified 92 children from her practice during the 2-year study period. To ensure that the patients evaluated at the different
Population characteristics
The 177 children included 145 (82%) males and 32 (18%) females. Ethnicity reflected the distribution of ethnic groups evaluated at the various centers and included 63% white, 11% black, 11% Hispanic, 6% Asian, and 8% of other or unknown ethnicity. The mean age at language regression was 22.8 months of age (range = 12-78 months) with a median age of 18 months. The distribution of the ages at regression is listed in Table 1. There were no significant differences in the reported ages at
Discussion
Language regression is generally the most salient feature of both autistic regression [1], [2], [3] and the Landau-Kleffner syndrome in which clinical seizures do not always occur [4], [5], [6], [14], [15]. Occurrence at any age should be an immediate cause for concern because it is not a feature of developmental delay and is only rarely a feature of developmental language disorders [1], [7], [16], [17]. In younger children, language regression usually is associated with a more global
Conclusion
The loss of previously acquired language at any age, even if that language only includes a few words or communicative gestures, has serious implications for future function. This loss often is associated with a more-global regression in cognition and/or behavior. The peak age for this regression is in the second year of age. Early identification and referral of these children is needed if progress is to be made in understanding the pathophysiology of these disorders and devising better
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