Regressive Autism - Why it Occurs

Regressive Autism Why It Occurs

Has your talkative, engaged, and very energetic child suddenly become quiet and uninterested? Does
your child exhibit new, unusual habits? If you answered yes, then, he/she may have what's called
regressive autism. Based on data from the US Centers for Disease Control and Prevention (CDC), one in
every 68 children in the US has autism, including regressive autism. The US federal government spends
more than $238 billion annually to help families treat and manage individuals with the condition.

In this article, we will discuss some facts about regressive autism, its signs and symptoms, possible
treatments, and the steps that may be taken by parents if they observe these signs in their children.

What is Regressive Autism?

Regressive autism, which is also called autism with regression, autistic regression, setback-type autism,
and acquired autistic syndrome, is a condition in which a child appears to develop typically but suddenly
begins to lose speech and social skills. These signs and symptoms are usually seen between the ages of
15 and 30 months. The loss of these skills can be very fast or can be very slow, and usually followed by a
lengthy period of stagnant skill progression.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) issued by the American
Psychiatric Association (APA) defines regressive autism as any type of autism spectrum disorder (ASD)
involving regression, including childhood disintegrative disorder.

It's vital that a child with regressive autism receives the proper diagnosis early on as well as the
appropriate therapies in an effort to reduce symptoms. Keep in mind all children with autism are
different and progress will be dependent on many factors.

Some Facts About Autism With Regression

Based on conducted studies by experts, the extent of social and academic impairment among children
with autism varies on a case by case basis. The various research also showed that children with autism
who were treated early following the discovery of their symptoms appeared to achieve more positive
outcomes. Here are other results of the different studies:

The diminishing skills in children with autistic regression were observed in an average age of 19
months. It was also observed that most of the children had already started to show slight delays
in development before they began to exhibit loss of words. However, the majority of kids with
regression have shown less apparent symptoms of their condition before their actual loss of
skills.
Almost 77 percent of children who suffered language loss have also experienced loss in
communication skills in nonverbal areas. The children who used to be very talkative and then
suddenly stopped talking exhibited a pattern of developing and losing nonverbal communication

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skills. These skills include imitation, direct eye contact, responding to their name, participation
in social games, receptive language skills before speech, and gestures.
There is a possibility that a regressive structure caused by genetic and environmental factors can
lead to the development of autistic behavior in children. This is because the patterns of
development observed by the parents of children with setback-type autism were not gradual
but immediate. According to the parents, they realized there was something wrong in their
children immediately.

Possible Causes of Autism in Kids

There have been various studies conducted on the possible causes of developmental delays and ASD in
children over the years. Some of these ASD experiments have resulted in positive findings, while others
failed. In the study conducted by researchers from the University of California, Davis titled Mitochondrial
Dysfunction in Autism, a possible biological cause of autism was identified. In their analysis, the
researchers found that autism or developmental delays can be due to a childs acquired loss of the
ability to produce energy in his/her cells, an increase in oxidative stress, and damage to the
mitochondria or the energy factories in cells. As brain function and neurodevelopment are highly
dependent on energy, the failure by the mitochondria to produce sufficient energy to fuel the brain may
result in developmental delays and possibly, autism.

Another breakthrough is the study led by Doctor Paul Ashwood of the Medical Investigation of
Neurodevelopmental Disorders (M.I.N.D.) Institute at the University of California, Davis. In the study,
Ashwood and his team found evidence linking autism regression with immune dysfunction, brain
changes, gastrointestinal (GI) distress, and severe repetitive behaviors. The researchers also discovered
elevated levels of the immune cells called dendritic cells in autistic kids. This immune abnormality is
suspected to be due to the enlargement of the amygdala, which is the part of the brain controlling
emotional responses. The study also showed that regressive autism is associated to the increased level
of plasmacytoid, which is a type of dendritic cell usually found in the peripheral lymphoid organs.

Moreover, a 2013 study led by Betty Diamond, head of The Feinstein Institute for Medical Researchs
Center for Autoimmune and Musculoskeletal Disorders in Long Island, New York, showed that autism
may be caused by the anti-brain antibodies which are able to penetrate the immature blood-brain
barrier of a developing fetus while in the womb. The antibodies may then cause damage to the fetus
brain, resulting to autism or developmental delays to the child when born.

Some Signs of Autism Regression in Children

Various studies showed around 25-30 percent of kids with ASD stop speaking after they start to say
some words, usually before they reach the age of two. Some of the children lose social development
instead of language, and some of them lose both. Here are other signs of autism with regression:

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Early Signs of ASD in a Child:

Avoids or doesn't like eye contact

Failure to respond when the child's name is called (the child may initially be suspected to be
deaf)
Inability to point at objects or things of interest, or failure to demonstrate interest
Generally wants to be alone
Failure to understand or to acknowledge other peoples feelings, as well as their own
Experiences echolalia or the tendency to repeat words and phrases uttered by other people
over and over again
Tends to give unrelated answers to questions asked to them
Obsessive interests
Loves to flap hands, spin in circles, and rock the body
Gets upset by minor changes in daily activities
Exhibits low to zero social skills
Shows unusual reactions like over- or under-sensitivity to the sound, smell, taste, look, and the
feel of various things
Tends to reverse the use of pronouns and use you instead of I
Detests or avoids physical contacts
Demonstrates little attention to safety and greatly unaware of danger

Other Signs and Symptoms of Autism

A child with autism may also exhibit such signs and symptoms as:

Impulsivity or acting without thinking

Extreme anxiety and phobias, as well as unusual phobias
Exhibits unusual interests and behaviors
Loves to play with toys the same way each time
Shows very active or hyperactive behavior
Exhibits unusual eating and sleeping habits
Exhibits strange mood or emotional reactions
Shows lack of fear or more fear than anticipated
Loves to line up toys or other objects
Exhibits a liking for specific parts of objects, such as the wheels of toy cars

Diagnostic Tools for Children Suspected with ASD

There are already lots of tools used by specialists and health professionals in testing and assessing
whether a child has ASD. In the so called multidisciplinary assessment, several specialists work together
in determining the real condition of a child. The multidisciplinary team usually includes a psychologist, a
speech pathologist, and a pediatrician or child psychiatrist. Conducting this assessment can result to a

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more accurate diagnosis and to the development of the best treatment plan if a child is diagnosed with
autism.

The test for determining if a child may have ASD consists of several procedures. These include watching
and observing how a child plays and interacts with others, conducting interviews to the parents of the
child, and reviewing and assessing the childs developmental history. The team of physicians also
measures the childs strengths and weaknesses in such areas as moving, communicating, and thinking.

Screening Tools for Assessing Possible ASD in Children

If you, as a parent or a carer, suspect a child may be exhibiting signs of ASD, here is a tool to help assess
and/or screen the child for possible symptoms of autism:

Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F)

This tool is a two-stage parent-report screening process to evaluate or assess possible ASD in
children. The tool is designed to effectively identify children 16 to 30 months of age who should
undergo a more comprehensive assessment or evaluation for possible early signs of
developmental delay or autistic behavior.

The checklist is one of the tools recommended by the American Academy of Pediatrics (AAP) for
screening children for possible ASD. The screening tool is implemented in two stages. The stages
are:

1. Developmental Screening

This is a short test to determine whether a child is learning the basic skills appropriate to his age
or he/she is experiencing some delays in learning. During the screening, the attending physician
may ask the parents several questions or talk and play with the child during the process to
observe how he/she learns, behaves, speaks, and moves. Any observable delays in these areas
may be a sign of autism. It is recommended that every child should be screened for
developmental disabilities and delays during regular doctor visits when he/she is 9-months old,
18-months old, and 24- or 30-months old.

2. Comprehensive Diagnostic Evaluation

This second and final step in the process is a comprehensive evaluation to thoroughly assess the
childs health and behavior. The process may include a hearing and vision screening, genetic
testing, neurological testing, and other medical testing. It also includes examining the childs
behavior and development, and interviewing the parents about the child and their family. In
some cases, the family doctor may refer the child and family to a specialist physician for

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additional diagnosis and evaluation. The specialist could be a developmental pediatrician, a child
psychologist, or a child neurologist.

Some test and screening tools for the diagnosis of ASD

When you suspect your child to be experiencing developmental delays, or possibly autism, you should
immediately take him/her to your family doctor, a pediatrician, or an autism specialist for further
evaluation and diagnosis. These health professionals usually use the DSM-5 manual to break down the
signs and symptoms of ASD into categories to effectively confirm a diagnosis of autism.

Here are some other tests and screening tools that can help in assessing if a child has autism:

Autism Diagnostic Interview, Revised (ADI-R)

Autism Diagnostic Observation Schedule, Second Edition (ADOS)
Modified Checklist for Autism in Toddlers (M-CHAT)
Childhood Autism Rating Scales, Second Edition (CARS-2)
Autism Behavior Checklist (ABC)
Psycho Educational Profile Third Edition (PEP-3)
Social Communication Questionnaire (SCQ)
Developmental Behavior Checklist (DBC)

Some Recommended Educational, Behavioral and Other Therapies for

Children with Autism

Experts have recommended the use of educational and behavioral therapies as possible treatments for
autistic kids because of their effectiveness, especially when combined with dietary and medical
interventions. The parents, siblings, and carers of children with ASD are encouraged to train for these
therapies in order for them to apply these treatments, themselves. These recommended therapies are:

1. Applied Behavioral Analysis (ABA)

This therapy mainly involves the services of a therapist who works intensely with a child in one-on-one
sessions for 20 to 40 hours per week. The sessions usually start with formally structured drills like
learning to point to a certain object when its name is given. In the sessions, the child is taught skills like
learning the various colors in a simple step-by-step process. ABA programs are claimed to be most
effective when they are started early (before the age of five), but they are also beneficial to older
children. Due to their effectiveness, various behavioral interventions have been developed that are
considered as ABA. The American Medical Association and the US Surgeon General have also
recommended the therapy for kids with ASD. It is, however, advised to parents to find another therapist
if their children are unhappy with their current one.

2. Speech Therapy

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As autistic children often have speech difficulties, conducting speech therapy may be very beneficial.
The use of sign languages, as well as picture exchange communication system (PECS) is also
recommended as a tool in developing speech in children with autism.

3. Sensory Integration

A number, if not all, individuals with autism have sensory issues in varying degrees from mild to severe,
so sensory therapies may be very beneficial for improvement. This therapy is focused mainly on three
senses, namely, vestibular or the senses of motion and balance, tactile or the sense of touch, and
proprioception or the sense of locomotion, movement or position. There are many techniques used in
sensory integration to normalize the senses of individuals with ASD.

4. Auditory Intervention

This therapy aims to improve the auditory processing of children with autism, as well as to eliminate
their sensitivity to sound and reduce their behavioral problems. There are various types of auditory
interventions like the Berard Auditory Integration Training (AIT), the Tomatis approach, the Samonas
Sound Therapy, and the Listening Program.

5. Vision Training and Irlen Lenses

These tools are intended to resolve the issues experienced by people with ASD with respect to their
visual environment and/or to their surroundings. Among such challenges may include a short attention
span, excessive eye movements, difficulty scanning or tracking movements, easily distracted, toe
walking, and being cautious when walking up or down the stairs. The conduct of a vision training
program involving the use of ambient prism lenses and visual-motor exercises may lessen or totally
eliminate many of the issues. The use of the colored or tinted lenses called Irlen lenses in the said
program is also proven to be effective in treating autistic individuals with hypersensitivity to certain
types of lighting like fluorescent lights and bright sunlight, as well as those with difficulty reading printed
texts.

6. Relationship Development Intervention (RDI)

This type of therapy is a family-based behavioral treatment designed to address a core issue of ASD,
namely, the development of social skills and friendships. This therapy was developed by psychologist
Steven Gutstein based on the theory that dynamic intelligence is key to enhancing the quality of life of
autistic people. The six main objectives of RDI are social coordination, declarative language, emotional
referencing, flexible thinking, foresight and hindsight, and relational information processing.

Training under this type of therapy usually starts with the parents or the caregivers of autistic children.
An RDI consultant conducts an extensive training to the parents or caregivers so that they may
effectively interact with their children. According to Doctor Gutstein, enhancing the relationship

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between the child and his/her parents or carers may result in improved brain function or neural
connectivity.

7. Steroid Therapy/Medications

This type of therapy may be effective as a treatment for individuals with regressive autism. Steroids
have been successfully used in treating related epileptic syndromes like the Landau-Kleffner syndrome
(LKS), which is linked to regression of speech and acquired epileptiform aphasia. Steroids have also been
proven to be effective as a treatment for multiple neurological disorders such as epilepsy, muscular
dystrophies, and encephalitis. In a study involving the drug prednisolone as a steroid therapy, the
children treated with the drug showed major improvements in their receptive and expressive language
skills, as well as in their frequency modulated auditory evoked response (FMAER). However, there are
possible side effects on the use of steroid as treatment so parents or carers of kids with autistic
regression should do several consultations with physicians before administering it to their children.

Some medications include the antidepressant drugs like Prozac (Fluoxetine), Lexapro, and Zoloft
(Sertraline), as well as the antipsychotic drug class such as Risperdal (Risperidone). These drugs are
effective in treating autism symptoms like anxiety, panic attacks, and aggression. It is recommended
that sufficient consultations with specialist physicians should be conducted first before giving these
drugs to individuals with ASD.

General Tips to Parents with Autistic Children

Caring for kids with autism can be challenging and tough for parents and carers. Here are some tips to
consider when caring for children in the spectrum:

Participate or become a member of one or more parent support groups or join a parent email
group. These are effective and wonderful sources of support and information for the care of
individuals with ASD.

Parents or carers should ensure their childrens diagnosis is accurate in order to obtain the
proper treatment. In some cases, physicians opt to give a softer diagnosis so the parents will
not be too worried. However, this may worsen the condition of a child because he/she will not
receive the appropriate treatment or medication.

Visit your local school district and inquire about the various programs they offer for children
with special needs.

You may contact your state or local governments and inquire about the services they provide to
help children with autism and their parents.

You should look for a physician who provides an integrated medical approach for treating
autism like medical and nutritional testing and treatments. You should find a doctor who is

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really willing to help your child rather than a physician who is just content in monitoring the
severity of your childs condition. You should also ensure that your physician supports you and
respects your viewpoint.

You should strive to manage your time well in order to provide time to attend to the needs of
your other children and your spouse. You should maintain open and positive communication to
all members of your family so you can effectively resolve all challenges that may come along in
the long term.

You should not stop researching on your own and learning new ways to help your child cope
with his/her challenges. Who knows, the solution you are looking/waiting for may already be on
the horizon.

Conclusion:

Regressive autism and the other types of autism spectrum disorders can be very challenging conditions
for both parents and their affected children. However, with the right strategies, a positive outlook, and
determination, these challenges can be identified and managed. The various advancements in medical
research showed that effective treatments are already in the horizon.

References:

http://nationalautismassociation.org/resources/signs-of-autism/

http://www.brighttots.com/Autism/Autistic_regression.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364648/

https://www.autismspeaks.org/science/science-news/immune-changes-linked-regression-gi-distress-
repetitive-behaviors

http://raisingchildren.net.au/articles/autism_spectrum_disorder_diagnosis.html

http://drhyman.com/blog/2010/12/09/breakthrough-discovery-on-the-causes-of-autism/

https://www.autism.com/understanding_advice

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