Friday, August 4, 2017

Rethinking regression in autism

The loss of abilities that besets some toddlers with autism is probably less sudden and more common than anyone thought.

Chawarska’s view echoes the findings of numerous studies that reveal a “range of onset patterns,” as University of Melbourne autism researcher Amanda Brignell and her colleagues explain in a 2016 paper, from ‘early onset’ (early developmental delays, no loss of skills) and ‘delay and regression’ (some early delays, then loss) to ‘plateau’ (no early delays and no loss, but a failure to gain) and ordinary ‘regression’ (no delays before a clear loss). These trajectories differ so much in their timing, speed, depth and effects that it requires a tangle of words and parentheticals to try to squeeze them into a binary framework.
Given all this, Ozonoff argues, we should speak not of regression, but of a variety of onsets: The true clinical picture of how autism begins to present is not two-tone or even spectral, but a complex kaleidoscope of possibilities. “I don’t even call it regression anymore,” she says. “I just think of it as onset: how symptoms start.”