The name is absent

Autism prodrome 33 of 89

pattern of abnormal brain growth and the phenomenon of regression whose timing
soon follows on (though it has yet to be established whether this is true for individual
children) is easy to understand.

The phenomenon of regression is yet not well understood. Some parents report
a very abrupt change in their child’s development, most notably when early language
skills are lost. Others report a much more gradual change over several months. There
is increasing recognition that social skills and interest, play skills and sometimes
(though more rarely) motor skills can also be lost or plateau (Davidovitch, Glick,
Holtzman, Tirosh, & Safir, 2000; Ozonoff, Williams, & Landa, 2005; Werner &
Dawson, 2005). In addition it is also now understood that some children may lose
language skills that are not a firmly embedded as the currently widely used definitions
from the ADI-R (Lord, Rutter, & Le Couteur, 1994) ‘loss of 5 words used
communicatively for at least 3 months’), that Baird et al. (2008) characterized as
‘lower level regression’. Ozonoff and colleagues (Hansen et al., 2008; Young &
Ozonoff, in press) have reviewed the evidence for whether pre-regression
development was clearly typical and the children were asymptomatic and concluded
that this is not the case. In fact children can show the full range of patterns with some
children showing early symptoms before their 1^st birthday and then losing skills whilst
others show no early signs but then undergo a regression (Young & Ozonoff, in
press). Across studies there is variability in the extent to which regression is
associated with poorer outcomes in terms of IQ, adaptive behavior or symptom
severity or even associated medical conditions such as gastro intestinal symptoms
(e.g. contrast the findings of Baird et al., 2008; Richler et al., 2006). Only in a
minority of cases is regression associated with the onset of seizures (Shinnar et al.,
2001; Tuchman & Rapin, 1997).

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