Children with autism spectrum disorders: a comparison of those who regress vs. those who do not.
Johnny L. Matson, PhD, Jonathan Wilkins, Jill C. Fodstad
Objective: While autism spectrum disorders (ASD) constitute a group of similar conditions, considerable heterogeneity in symptoms of these neurodevelopmental disorders have been noted. One of the most important, yet least studied, of these factors is developmental regression.
Methods: One-hundred and twenty-five children were studied and broken down into the following three groups: ASD children with and without substantial regression and typically developing children. In study one, the three groups were compared on global measures of ASD symptomatology, comorbid psychopathology, challenging behaviour and social skills. In study two, the two ASD groups were compared on each individual item from the dependent measures.
Results: Mean age when regression occurred was 27.76 months. The ASD children as a whole differed from the typically developing controls, showing more symptoms of ASD, as would be expected, and poorer social skills, while differences were also noted between the two ASD groups.
Conclusions: It was determined that children with ASD who regress present with a distinct behavioural profile when compared to children with ASD who do not regress, which included greater levels of impairment on global measures of ASD symptomatology, comorbid psychopathology, challenging behaviour and social skills.
It has long been thought (or speculated at least) that children who regress into autism are different than children who show signs of it from birth or simply fail to acquire skills when they should. Yet, there has not been much research into the exact differences between the two groups. This is one of the first studies that I have seen that says that there is a behavioral difference between the groups.
It is my belief that this regressive group is more likely to have a form of autism that is "triggered" by something rather than to have a purely genetic form and should be broken out separately from other forms of autism in research studies. Yet, up until now, I have not seen anybody suggest that it would be possible to separate the two groups. Perhaps it would be possible if regressive autism has slightly different behaviors associated with it.
Interesting.
Your link didn't work -- probably something futzed in the link.
ReplyDeleteI agree that it is interesting.
Dev Neurorehabil. 2010 Oct;13(1):37-45.
Children with autism spectrum disorders: a comparison of those who regress vs. those who do not.
Matson JL, Wilkins J, Fodstad JC.
PMID: 20067344 [PubMed - in process]
Apparently, doesn't have a DOI yet.
Mean age when regression occurred was 27.76 months.
Hmmn. That's well after the "too many, too soon" mantra.
I fixed the link, thanks.
ReplyDelete"Hmmn. That's well after the "too many, too soon" mantra."
I am not sure if we can draw that conclusion from a simple number. I don't have the study text (yet) so I have no idea of the number of children in the regression group nor the standard deviation of that group.
We could be talking +/- 18 months or +/- 1 month, or anything in between.
It is my belief that this regressive group is more likely to have a form of autism that is "triggered" by something rather than to have a purely genetic form and should be broken out separately from other forms of autism in research studies.
ReplyDeleteIf that were the case you would have to explain onset of schizophrenia in late adolescence or early 20's when it is thought to have a high heritable component. Also you would have to explain Huntington's chorea which usually occurs after the age of 50 and is known to be caused by one autosomal dominant gene.
I was told I had regressive autism starting from about age two and a half when I had speech but then it gave out and then I partially recovered (although not 100%) at age 4. There is a history of serious depression and learning disabilities in my family so it is likely there is at least a partial genetic component in my case.
Jonathan,
ReplyDeleteIn the case of schizophrenia I think some of the latest research is showing that the it is genetic and environmental in origin. For example -
http://www.sciencedaily.com/releases/2010/01/100128142145.htm
"The onset of schizophrenia is not easy to predict. Although it is associated with as many as 14 genes in the human genome, the prior presence of schizophrenia in the family is not enough to determine whether one will succumb to the mind-altering condition. The disease also has a significant environmental link."
I think regressive autism will be similar. When there is clear loss of previous skills I am thinking that there is something else going on other than the traditional line of "brain growing badly" theories that go along with the genetic model of autism. A brain is not going to suddenly and spontaneously lose connectivity or previously acquired skills without some event causing it.
I don't know that much about Huntington's so I can't comment on that.
My twin daughters seem to have a mix of regressive and typical autism. Their regression happened at about a year old and they did lose some skills and after that they didn't acquire skills like they should.
However, my youngest daughter have a milder form of autism and she did not have a regression. There was never a point where she lost previously acquired skills but her acquisition of skills did slow.
In both cases I am sure that there is some genetic component and at the same time the autism was made worse in my older daughters by their regression. If they did not regress, I suspect they would be on the milder side like my youngest.
My cousin is profoundly LFA and did regress.
ReplyDeleteI did not.
I sometimes wonder if the difference is not between "HFA" and "LFA" but between regressive and non-regressive autism.
I have always believed that regressive autism is more severe than non-regressive autism because that is just what I see. Vaccines are usually to blame with regressive autism, not simply because it is around the same time but because it is often so severe.
I ran across this classification here -
ReplyDeletea) normal development until at least age 12 m followed by loss of previously achieved developmental milestones prior to 24 m, accompanied by the appearance of typical autistic behaviors
b) normal development until at least age 12 m followed by developmental plateauing whereby milestones were not noticeably lost but development suffered marked deceleration, accompanied by appearance of typical autistic behaviors
c) definite onset of autistic behaviors prior to age 12 m
I think that is the best summary of the different types of regression vs non-regressive that I have seen.
"Mean age when regression occurred was 27.76 months."
ReplyDeleteThe researchers did not publish an SD with their study, but the range of ages for the regression was 4 months to 10 years. I think having such a wide range makes this figure mostly worthless.
Hello all! I am one of the authors of the paper you are commenting on. If no one has actually read the article, there are SDs in the full-text. If you any specific questions regarding our paper, please leave them here and I will try to answer them.
ReplyDeleteThanks!
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