Assessment & Research

Language and other regression: assessment and timing.

Goldberg et al. (2003) · Journal of autism and developmental disorders 2003
★ The Verdict

A simple parent interview form can pin down when and what skills vanished in toddlers with ASD.

✓ Read this if BCBAs who assess toddlers with suspected autism in clinic or early-intervention settings.
✗ Skip if Practitioners working only with older or non-regression clients.

01Research in Context

01

What this study did

The team built a one-page Regression Supplement Form. It asks parents exact ages when each skill vanished.

They tried it with 44 children who already had an ASD diagnosis. All kids showed language loss, and many also lost play, social, or self-care skills.

02

What they found

The form caught two clear groups. One group lost words only. The other group lost words plus other skills like pointing or toilet use.

Most losses happened between 18 and 24 months, matching the stories parents told.

03

How this fits with other research

Sharp et al. (2010) later tracked the kids and found the same age window. They also showed that children with regression-only onset often end up with more severe symptoms.

Tan et al. (2021) pooled 75 studies and reported that about 30 % of kids with ASD lose skills, most around 20 months. Their big-picture numbers line up with the small case series.

Hus et al. (2014) and de Bildt et al. (2011) worked on calibrating ADOS scores. Like the Regression Form, their goal was to give clinicians a ruler that gives the same number no matter who uses it.

04

Why it matters

You now have a free, ready-to-copy interview sheet that turns vague “he stopped talking” into exact months and lost skills. Use it at intake to spot regression early, document it for insurance, and plan heavier intervention for kids in the word-plus-other-skills group.

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Print the Regression Supplement Form, add it to your intake packet, and ask every new parent for the exact month each skill disappeared.

02At a glance

Intervention
not applicable
Design
case series
Sample size
44
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Understanding of regression in autism has been hampered by variability in parental and clinical recognition and reporting of lost skills. This study introduced an instrument, the Regression Supplement Form, intended to supplement the Autism Diagnosis Interview-Revised and yield precise information about the types and timing of regression and events concurrent with loss and regain of skills. Data were collected from parents of 44 children (38 male, 6 female; mean age = 6 years) with Autistic Spectrum Disorder (37 Autistic Disorder, 7 Pervasive Developmental Disorder-Not Otherwise Specified). Parental responses on the Autism Diagnosis Interview-Revised indicated loss of skills during early development. The profile of regression that emerged included loss of skills between 18 and 21 months, on average, with language-only regression less common than loss of other, nonlanguage skills only or of full regression (loss of language and other skills). The onset of regression typically was gradual in nonlanguage areas and split between gradual and sudden loss for language skills. Some of the children were developing atypically before they lost other, nonlanguage skills, that is, their age at first words was delayed until age 2 years or older. Parents tended to attribute loss to medical factors such as immunizations. Many of the children regained some of the lost skills when they were 3.5-5 years of age, with therapeutic and instructional interventions given credit for the regain.

Journal of autism and developmental disorders, 2003 · doi:10.1023/b:jadd.0000005998.47370.ef