Just as he turns 19 months old, a child suddenly loses his interest in playing peek-a-boo. Skills that he was just learning to acquire — making eye contact, using gestures and forming meaningful words — are mysteriously lost. The child, who seemed to be developing normally during his first year and a half, is now displaying signs of abnormal behavior, repeating actions over and over and becoming excessively attached to certain objects.
His parents make a difficult realization: Their child has autism.
For a considerable minority of children with autism — 20 to 40 percent — the first signs of their disorder became apparent in a phenomenon known as regression. Unlike the majority of autistic children, who from the beginning of their lives show impaired development, children with autism and regression develop seemingly normally for the first 15 to 24 months of their lives, and then they begin to show a drastic decline in social and cognitive ability.
Recent findings by University researchers tracks the path of regression in a subset of children with autism indicating that children do not suddenly become autistic after developing normally for a year and a half. The studies will be published in upcoming issues of Developmental Psychology and the Journal of Autism and Developmental Disorders.
In the studies gathered information from more than a 1,000 children diagnosed with autism at 13 testing sites nationwide, including the University’s Autism and Communication Disorders Center.
The “largest-known study of its kind,” according to a University press release, researchers were able to shed light on the differences between autistic children without regression and those with it. Early on in their lives, autistic children with regression show more social and communication skills, as measured by standardized diagnostic tests, than children with autism and no regression.
After the onset of regression, however, these children are impaired to an equal or greater degree as autistic children without regression. This effect, so far, has been observed for years afterward.
For this subset of autistics, those with regression start ahead of afflicted newborns but end behind in measures of social and psychological impairment.
Jennifer Richler, one of the lead researchers of the study and a psychology graduate student instructor, said this finding “dispels a common misconception that children with autism who regress were developing completely normally before they regressed.” She rejected the notion of children “becoming autistic,” and suggested that parents may not notice the slight impairment of their child before major onset of autistic symptoms.
The findings also dispelled a connection between early-life vaccination and autism. Fears surfaced several years ago that the administration of the measles/mumps/rubella vaccine might be connected to autism, but “many large population-wide studies have found no evidence for such a link,” Richler. said
There was also no link between the vaccine and the regressive form of autism.
However, the study found other links. Interviews with parents of autistic children showed that there was a connection between the disorder and a family history of autoimmune disease.
While the authors of the papers acknowledged the help of parents of autistic children who chose to participate in the studies, the reliance on interviews and the memories of their developing children was an admitted limitation on the data collected.
Future directions in autism research will focus on understanding the causes and markers of the disorder and identifying children in the process of regressing, using genetic or neurobiological methods. Then, instead of relying on “retrospective parent report,” Richler said, “we might intervene at that point and help the child right then, rather than waiting until they have lost more skills.”