Phenotypic characteristics and rehabilitation effect of children with regressive autism spectrum disorder: a prospective cohort study
Kids with regressive autism under four can still make solid gains from a year of ABA; older kids need a different plan.
01Research in Context
What this study did
Hu et al. (2024) tracked children with regressive autism for one year. All kids got the same behavioral intervention. The team measured autism symptoms and developmental scores before and after.
They split the group by age: under four and four plus. The goal was to see who gained the most.
What they found
Younger kids with regressive autism made clear gains. Older kids showed little change.
Core autism symptoms eased and developmental scores rose, but only for the under-four group.
How this fits with other research
The result lines up with Boterberg et al. (2019) and Sharp et al. (2010). Those papers already showed that children who lose skills later end up with more severe symptoms. Hu now shows they also gain less from therapy.
da Silva et al. (2023) saw skill gains after 12 months of ABA in a mixed group. Hu narrows this to regressive kids and adds the age cutoff.
Cavézian et al. (2010) found no link between more hours and better outcomes. Hu still found positive change, but only in the younger set. The clash hints that age, not dose, drives progress.
Why it matters
If you work with toddlers who lost words or skills, start intensive ABA now. The window closes fast. For kids over four with regression, plan for longer or different supports. Screen early, act early, and track age as a key variable in your treatment decisions.
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02At a glance
03Original abstract
In this prospective cohort study, we determined the phenotypic characteristics of children with regressive autism spectrum disorder (ASD) and explored the effects of rehabilitation. We recruited 370 children with ASD aged 1.5–7 years. Based on the Regression Supplement Form, the children were assigned to two groups: regressive and non-regressive. The core symptoms and neurodevelopmental levels of ASD were assessed before and after 1 year of behavioral intervention using the Autism Diagnostic Observation Schedule (ADOS), Social Response Scale (SRS), Children Autism Rating Scale (CARS), and Gesell Developmental Scale (GDS). Among the 370 children with ASD, 28.38% (105/370) experienced regression. Regression was primarily observed in social communication and language skills. Children with regressive ASD exhibited higher SRS and CARS scores and lower GDS scores than those with non-regressive ASD. After 1 year of behavioral intervention, the symptom scale scores significantly decreased for all children with ASD; however, a lesser degree of improvement was observed in children with regressive ASD than in those with non-regressive ASD. In addition, the symptom scores of children with regressive ASD below 4 years old significantly decreased, whereas the scores of those over 4 years old did not significantly improve. Children with regressive ASD showed higher core symptom scores and lower neurodevelopmental levels. Nevertheless, after behavioral intervention, some symptoms exhibited significant improvements in children with regressive ASD under 4 years of age. Early intervention should be considered for children with ASD, particularly for those with regressive ASD. The online version contains supplementary material available at 10.1186/s12888-024-05955-1.
BMC Psychiatry, 2024 · doi:10.1186/s12888-024-05955-1