ReviewAutistic regression
Section snippets
Prevalence
The overall rate of autism, once thought to be rare, is now considered a frequently occurring and highly debilitating condition. Rice (2007), for example, found rates of 6.7 per 1000 from a total cohort of 1252 children, all 8 years of age from 6 states. Furthermore, these rates are increasing. Improved methods of detection, changes in diagnostic criteria and state and federal administrative changes favoring identification are considered to be some possible explanations for this phenomenon (
Nosology: early symptom presentation
A variety of symptoms are useful for differentiating small children with autism and pervasive developmental disorders not otherwise specified (PDD-NOS) from typically developing infants and toddlers. Mooney, Gray, and Tonge (2006), for example, evaluated 55 children between 22 and 51 months of age. They found that complex repetitive and stereotyped responses such as circumscribed interests, obsessions compulsions, rigid adherence to routine and rituals, insistence on sameness and “abnormal”
Age of onset
When exactly does regression occur and what does it look like? Matson, Wilkins, and Fodstad (in press) report that the mean age of regression was 27.7 months and typically occurred over a 3-month period of time, with particularly pronounced regression in communication and social behavior. Amorosa and Noterdaeme (2002) also noted that the greatest regression was in these two core skill areas. These data are consistent with observations made by Ritvo and Freeman (1977) that speaking ability may
Nosology: physical development
Along with regression in core symptoms of autism, a variety of developmental skills also tend to be effected. Moretti et al. (2008), for example, studied seven children who experienced autistic regression. They reported psychomotor retardation for all of the children as well as delays in cognitive development and dyskinesia. Additionally, six of the children had seizures, four demonstrated neurological abnormalities in the neonatal period and two evinced serious neurological abnormalities.
Nosology: communication
For young children with autism, language and other communication impairments differ and are related to other skill deficits. Thus, individuals with delayed language acquisition evince bilateral impairments on visual motor discrimination tasks. Conversely, children with autism but without language delay showed marginal impairments in the left hemisphere of the brain. These and other sensorimotor disturbances are thus more prevalent in children with ASD, but the type and severity of these
Etiology
To date, the research on the etiology of autistic regression is largely correlational although prenatal contributions to epilepsy (two or more seizures not induced by drugs or environmental factors) have been hypothesized (Scher, Kidder, & Bangert, 2007). Perhaps the most researched of these factors to date are epilepsy and persons with intellectual disabilities, which overlap at high rates in persons with autistic regression (Oslejsková et al., 2008). These authors note that 60.6% of 71
Treatment
There is no specific intervention model for autistic regression. The main stay for intervention at this point is applied behavior analysis (ABA), but the conceptual model is more in line with treating specific “target behaviors” with little focus on underlying mechanisms such as seizures, which occur often in autistic regression, and how it might be related to this phenomenon. If such a relationship exists, and as expected antiepileptic drugs (AEDs) are successful in treating seizures and core
Conclusions
The definition, etiology and diagnostic methodology for the study of ASD has grown and changed rapidly. Research has emerged focusing on autistic regression and its relationship to ASD as a whole. However, research efforts in this area have not kept pace with developments on the nature, assessment and treatment of ASD as a whole. This profile would suggest the need for much more focus on the topic.
What appears to be emerging with respect to autistic regression is that it presents with a
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Cited by (22)
Regression in autism spectrum disorder: A critical overview of retrospective findings and recommendations for future research
2019, Neuroscience and Biobehavioral ReviewsAddressing sequelae of developmental regression associated with developmental disabilities: A systematic review of behavioral and educational intervention studies
2019, Neuroscience and Biobehavioral ReviewsCitation Excerpt :Another limitation relating to the scope of the available literature is that no studies involving participants specifically identified as having ASD with developmental regression were identified. This is surprising given that developmental regression has been reported to occur in 20 to 50% of individuals with ASD (Barger et al., 2013; Matson and Kozlowski, 2010; Ozonoff et al., 2018) and that the autism spectrum now also subsumes individuals who, prior to 2013, would have been diagnosed with CDD. While there is a large literature on behavioral and educational interventions for individuals with ASD (Matson, 2017), the results of our search did not identify any intervention studies explicitly focused on addressing developmental regression in persons with ASD.
Promoting constructive engagement by two boys with autism spectrum disorders and high functioning through behavioral interventions
2014, Research in Autism Spectrum DisordersCitation Excerpt :These results are supported by a slightly higher levels of constructive engagement showed in the former condition. Moreover, the greater appeal for computer use could be due to a larger variety of stimuli provided by the computer software with respect to the coloring activity, which may encounter with sensory saturation (Matson & Kozlowski, 2010). Beneficial effects of the computer condition on stereotyped behaviors are evident during the fourth phase, in which baseline and intervention were alternated.
Using iPods<sup>®</sup> and iPads<sup>®</sup> in teaching programs for individuals with developmental disabilities: A systematic review
2013, Research in Developmental DisabilitiesCitation Excerpt :For example, only a few studies addressed academic and employment skills and no studies addressed social skills. The latter is an especially important priority for individuals with ASD and intellectual disability (Matson & Kozlowski, 2010). Future studies should also focus on using iPads® and related technologies to teach daily-living skills, such as sandwich preparation, grocery purchasing, conceptual skills (e.g., money, numbers, and time).
Convergent validity of the autism spectrum disorders-diagnostic adult (ASD-DA) with the pervasive developmental disorder/autism subscale of the diagnostic assessment for the severely handicapped-II (DASH-II)
2012, Research in Autism Spectrum DisordersCitation Excerpt :The scale can be completed relatively quickly and is useful in identifying persons with autism. Additionally, the ASD-DA is unique in that in addition to measuring autistic symptoms, it also assesses for various forms of psychopathology and challenging behaviors, which are common in individuals with autism and IDs (Holden & Gitlesen, 2009; LoVullo & Matson, 2009; Matson & Kozlowski, 2010; Matson, Mahan, Fodstad, et al., 2010; Matson, Mahan, Hess, Fodstad, & Neal, 2010; Moree & Davis, 2010; O’Reilly et al., 2010; Ward & Gilmore, 2010). Additionally, it is one of the few measures available for adults with severe and profound ID.
Speech deficits in persons with autism: Etiology and symptom presentation
2012, Research in Autism Spectrum DisordersCitation Excerpt :The most studied phenomenon to date involves autistic regression. Though this topic implies a variety of skills are lost, communication deficits are among the most significant (Matson & Kozlowski, 2010). Luyster et al. (2005) reported poorer receptive language while Stein, Dixon, and Cowan (2000) described very limited vocabulary and considerable repetition in skills.