Elsevier

Research in Autism Spectrum Disorders

Volume 4, Issue 3, July–September 2010, Pages 340-345
Research in Autism Spectrum Disorders

Review
Autistic regression

https://doi.org/10.1016/j.rasd.2009.10.009Get rights and content

Abstract

Autistic regression is one of the many mysteries in the developmental course of autism and pervasive developmental disorders not otherwise specified (PDD-NOS). Various definitions of this phenomenon have been used, further clouding the study of the topic. Despite this problem, some efforts at establishing prevalence have been made. The purpose of this review was to cover these topics in the context of topics such as descriptive symptoms, age of onset, effects on physical development and language, and discussions of research specific to etiology and treatment. Current status of the research on the topic and future directions are discussed.

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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