Sunday, January 7, 2018

Rethinking regression in autism

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

One of the oldest ideas in autism — as old as the naming of the condition itself — is that it comes in two forms: one present from birth, and one that abruptly emerges in toddlerhood. The latter type, or so the idea goes, announces itself through a rapid loss of skills.
In this classic picture of ‘regression,’ a talkative, curious 2-year-old suddenly withdraws. He grows indifferent to the sound of his name. He begins to speak less than before or stops entirely. He turns from playing with people to playing with things, from exploring many objects and activities to obsessing over a few. He loses many of the skills he had mastered and starts to rock, spin, walk on his toes or flap his hands. It’s often at this point that his terrified parents seek answers from experts.
Today, Ozonoff, professor of psychiatry and behavioral sciences at the University of California, Davis MIND Institute, is one of a growing cohort of researchers who say the simple split between regressive and non-regressive autism is almost certainly wrong. Their proposal, which has gained momentum over the past 15 years, is that researchers and clinicians should retire the division for good.
“I think most kids with autism lose some skills, but how many they lose — and when they lose and what they lose — varies across kids,” says Catherine Lord, director of the Center for Autism and the Developing Brain at New York-Presbyterian Hospital in New York City. “I think classifying them as regressive or non-regressive is a waste of time and a misnomer.”