Risk factors and clinical characteristics of autism spectrum disorder with regression in China.
Kids who lose skills after fever or diarrhea need stronger social and stereotypy interventions.
01Research in Context
What this study did
Han et al. (2023) compared two groups of Chinese children with autism. One group lost early skills, called ASD-R. The other group never lost skills, called ASD-NR.
Doctors looked back at medical charts. They wanted to find body events that happened before the skill loss.
What they found
Kids with ASD-R had worse social-communication scores and more repetitive movements than kids with ASD-NR.
Two body events stood out: fever and diarrhea before regression. These were flagged as possible warning signs.
How this fits with other research
Grzadzinski et al. (2018) seems to say the opposite. They found that 17 % of kids with autism actually look better during fever. The trick is in the groups. Lu studied kids who lost skills after fever. Rebecca studied kids who briefly improved during fever. Different kids, different stories.
Gyamenah et al. (2024) also link gut problems to autism. They showed that early social-communication delays predict later constipation. Lu adds diarrhea before regression to the same gut-behavior picture.
Kocher et al. (2015) asked parents about cause beliefs. Parents who saw regression were more likely to blame vaccines. Lu gives those parents a new data point: the fever or diarrhea that came first.
Why it matters
When you intake a new client, ask parents: "Did your child have any fever or stomach bugs right before the skill loss?" Chart the answer. If the answer is yes, plan for more intense social-communication targets and extra stereotypy reduction from day one. Share the fever-improvement note with pediatricians so they know fever can look good in some kids but signal risk in others.
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02At a glance
03Original abstract
Autism spectrum disorder with regression (ASD-R) is characterized by the loss of previously acquired skills during the initial year of life. This study aimed to investigate the clinical characteristics, patterns of regression, and potential risk factors associated with ASD-R in the Chinese Han population. A case-control study was conducted between September 2020 and March 2022. A total of 186 children were enrolled, including 58 children with ASD-R, 70 with ASD without regression (ASD-NR), and 58 typically developing children. Demographic information, clinical characteristics, and potential risk factors related to ASD-R were assessed using a combination of questionnaires, interviews, and physician assessments. The results revealed that children with ASD-R exhibited more severe impairments in social communication and stereotyped behaviors compared with those with ASD-NR. Language regression, constituting 40% of cases within the ASD-R group, was found to be the most common type of regression. Furthermore, our analysis revealed that fever (OR = 4.01, 95% CI: 1.26-12.76) and diarrhea (OR = 6.32, 95% CI: 1.38-29.03) were identified as significant risk factors for ASD-R. These findings contribute to our understanding of the heterogeneity of ASD and highlight the importance of considering immune responses and gastrointestinal factors in the etiology of ASD-R.
Autism research : official journal of the International Society for Autism Research, 2023 · doi:10.1002/aur.3008