Developmental regression among children with autism spectrum disorder: Onset, duration, and effects on functional outcomes
Developmental regression among children with autism spectrum disorder: Onset, duration, and effects on functional outcomes
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DOI：
10.1016/j.rasd.2014.04.002
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发表时间：
2014-07-01
影响因子：
2.5
通讯作者：
Hus, Vanessa
中科院分区：
文献类型：
--
作者：
Goin-Kochel, Robin P.;Esler, Amy N.;Hus, Vanessa
使用各种方法的研究表明，相当大比例的自闭症谱系障碍 (ASD) 儿童出现发育退化。关于退化是否与较差的认知和适应功能相关，研究结果是模棱两可的。本研究检查了 2105 名患有自闭症谱系障碍 (ASD) 的 Simons Simplex Collection 参与者的回顾性家长报告。使用自闭症诊断访谈修订版 (ADI-R) 和补充访谈中的项目来捕获更微妙的回归，将儿童分为语言和/或其他技能“完全”或“阈下”损失。总体而言，36.9% 的儿童出现某种类型的退化（27.8% 的语言能力下降，27.0% 的其他技能下降），补充访谈捕获了仅使用 ADI-R 可能漏掉的 11.7% 的下降。该数字与之前的家长报告研究一致，但低于前瞻性调查中临床医生观察到的比率。早期语言完全或低于阈值的丧失以及其他技能的完全丧失似乎与童年中期更有害的结果有关。研究结果可能表明，即使是轻微技能损失的儿童，尤其是语言技能损失，也需要更直接和/或更强烈的治疗。结果进一步证明了一组扩展的附加查询的实用性，这些查询的标准略有修改，可以捕获这种早期的、微妙的损失。 (c) 2014 Elsevier Ltd. 保留所有权利。
Studies using varied methods report that developmental regression occurs in a sizeable proportion of children with autism spectrum disorder (ASD). Findings are equivocal as to whether regression is associated with poorer cognitive and adaptive functioning. This study examined retrospective parent report in 2105 Simons Simplex Collection participants with ASD. Children were classified as having "full" or "subthreshold" losses on language and/or other skills using items from the Autism Diagnostic Interview-Revised (ADI-R) and a supplemental interview to capture more subtle regressions. Overall, 36.9% of children had some type of regression (27.8% language, 27.0% other-skill loss), with the supplemental interview capturing 11.7% of losses that would have been missed using the ADI-R alone. This figure is consistent with previous parent-report studies but lower than clinician-observed rates in prospective investigations. Early language losses either full or subthreshold and full other-skill losses appear to be associated with more deleterious outcomes by middle childhood. Findings may signify the need for more immediate and/or intense therapies for children who have even minor skill losses, particularly in language skills. Results further demonstrate the utility of an expanded set of additional queries with slightly modified criteria to capture such early, subtle losses. (c) 2014 Elsevier Ltd. All rights reserved.