Description of Clinician-Diagnosed Regression at Time of Autism Spectrum Disorder Diagnosis in Toddlers.
Journal
Journal of developmental and behavioral pediatrics : JDBP
ISSN: 1536-7312
Titre abrégé: J Dev Behav Pediatr
Pays: United States
ID NLM: 8006933
Informations de publication
Date de publication:
01 09 2022
01 09 2022
Historique:
received:
29
06
2021
accepted:
27
01
2022
pubmed:
1
4
2022
medline:
15
9
2022
entrez:
31
3
2022
Statut:
ppublish
Résumé
Previous studies have reported varying rates of regression in children with autism spectrum disorder (ASD). We sought to (1) determine the rate of clinician-diagnosed regression for young children with ASD and (2) compare developmental functioning and ASD symptoms of children with versus without regression. We conducted a retrospective chart review of toddlers (age 18-36 months) with Diagnostic and Statistical Manual-5 ASD. We abstracted cognitive, language, adaptive, and motor functioning standard scores and ASD core symptoms. Regression was defined as "clinician-diagnosed regression accompanied by recommendation for a medical workup." We used propensity scores to match each participant with regression (n = 20) one-to-one with a participant without regression (n = 20). We compared the groups on developmental scores using independent sample t tests and on core ASD symptoms using Pearson's χ 2 test. Of the 500 children with ASD, n = 20 (4%) had regression (defined above). Children with regression had lower Bayley cognitive and language scores and lower Vineland adaptive scores compared with those without regression (cognitive: 78.0 vs 85.5, p < 0.05; language: 56.9 vs 68.2, p < 0.01; adaptive: 70.0 vs 80.3; p < 0.01). There was no difference in motor scores across groups. There were no significant differences in the frequency of exhibiting core ASD symptoms for those with versus without regression. In this clinical sample of children with ASD, regression was diagnosed in a small percentage (4%). Those with regression had lower cognitive, language, and adaptive skills compared with those without regression. Rates of clinician-diagnosed regression referred for medical workup are significantly lower than prior estimates based on parent report.
Identifiants
pubmed: 35358102
doi: 10.1097/DBP.0000000000001080
pii: 00004703-202209000-00001
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
377-385Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: The authors declare no conflict of interest.
Références
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.
Giannotti F, Cortesi F, Cerquiglini A, et al. Sleep in children with autism with and without autistic regression. J Sleep Res. 2011;20:338–347.
Barbaresi WJ. The meaning of “regression” in children with autism spectrum disorder: why does it matter? J Dev Behav Pediatr. 2016;37:506–507.
Ozonoff S, Iosif AM. Changing conceptualizations of regression: what prospective studies reveal about the onset of autism spectrum disorder. Neurosci Biobehavioral Rev. 2019;100:296–304.
Baird G, Charman T, Pickles A, et al. Regression, developmental trajectory and associated problems in disorders in the autism spectrum: the SNAP study. J Autism Dev Disord. 2008;38:1827–1836.
Rutter M, LeCouteur A, Lord C. Autism Diagnostic Interview—Revised. Los Angeles: Western Psychological Associates; 2008.
Hansen RL, Ozonoff S, Krakowiak P, et al. Regression in autism: prevalence and associated factors in the CHARGE Study. Ambul Pediatr. 2008;8:25–31.
Werner E, Dawson G, Munson J, et al. Variation in early developmental course in autism and its relation with behavioral outcome at 3-4 years of age. J Autism Dev Disord. 2005;35:337–350.
Lam KS, Bodfish JW, Piven J. Evidence for three subtypes of repetitive behavior in autism that differ in familiality and association with other symptoms. J Child Psychol Psychiatry. 2008;49:1193–1200.
Jones LA, Campbell JM. Clinical characteristics associated with language regression for children with autism spectrum disorders. J Autism Dev Disord. 2010;40:54–62.
Meilleur AA, Fombonne E. Regression of language and non-language skills in pervasive developmental disorders. J Intellect Disabil Res. 2009;53:115–124.
Parr JR, Le Couteur A, Baird G, et al. Early developmental regression in autism spectrum disorder: evidence from an international multiplex sample. J Autism Dev Disord. 2011;41:332–340.
Lombardi LM, Baker SA, Zoghbi HY. MECP2 disorders: from the clinic to mice and back. J Clin Invest. 2015;125:2914–2923.
Sanmann JN, Schaefer GB, Buehler BA, et al. Algorithmic approach for methyl-CpG binding protein 2 (MECP2) gene testing in patients with neurodevelopmental disabilities. J Child Neurol. 2012;27:346–354.
Weissman JR, Kelley RI, Bauman ML, et al. Mitochondrial disease in autism spectrum disorder patients: a cohort analysis. PLoS One. 2008;3:e3815.
Hyman SL, Levy SE, Myers SM. Council on children with disabilities SOD, behavioral P. Identification, evaluation, and management of children with autism spectrum disorder. Pediatr. 2020;145:e20193447.
Thompson L, Gillberg C, Landberg S, et al. Autism with and without regression: a two-year prospective longitudinal study in two population-derived Swedish cohorts. J Autism Dev Disord. 2019;49:2281–2290.
Tuchman RF, Rapin I. Regression in pervasive developmental disorders: seizures and epileptiform electroencephalogram correlates. Pediatrics. 1997;99:560–566.
Bradley CC, Boan AD, Cohen AP, et al. Reported history of developmental regression and restricted, repetitive behaviors in children with autism spectrum disorders. J Dev Behav Pediatr. 2016;37:451–456.
Manelis L, Meiri G, Ilan M, et al. Language regression is associated with faster early motor development in children with autism spectrum disorder. Autism Res. 2020;13:145–156.
Bayley N. Manual for the Bayley Scales of Infant and Toddler Development. 3rd ed. San Antonio: The Psychological Corporation; 2006.
Sparrow S, Balla D, Cicchetti D. Vineland Adaptive Behavior Scales-Interview Edition. Circle Pines, MN: AGS; 1984.
Harstad EB, Fogler J, Sideridis G, et al. Comparing diagnostic outcomes of autism spectrum disorder using DSM-IV-TR and DSM-5 criteria. J Autism Dev Disord. 2015;45:1437–1450.
Harris HK, Sideridis GD, Barbaresi WJ, et al. Pathogenic yield of genetic testing in autism spectrum disorder. Pediatrics. 2020;146:e20193211.
Harris HK, Lee C, Sideridis GD, et al. Identifying subgroups of toddlers with DSM-5 autism spectrum disorder based on core symptoms. J Autism Dev Disord. 2021;28:4471–4485.
Werner E, Dawson G. Validation of the phenomenon of autistic regression using home videotapes. Arch Gen Psychiatry. 2005;62:889–895.
Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–381.
Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for casual effects. Biometrika. 1983;70:41–55.
Efron B, Tibshirani R. Bootstrap methods for standard errors, confidence intervals, and other measures of statistical accuracy. Stat Sci. 1986;1:54–77.
Ozonoff S, Iosif AM, Baguio F, et al. A prospective study of the emergence of early behavioral signs of autism. J Am Acad Child Adolesc Psychiatry. 2010;49:256–266 e251252.
Ozonoff S, Gangi D, Hanzel EP, et al. Onset patterns in autism: variation across informants, methods, and timing. Autism Res. 2018;11:788–797.
Charman T, Taylor E, Drew A, et al. Outcome at 7 years of children diagnosed with autism at age 2: predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time. J Child Psychol Psychiatry. 2005;46:500–513.