Autism Spectrum Disorder (
There are several medical conditions that have been recognized with relatively high frequency in individuals with Autistic Spectrum Disorder (
Regression in individuals with Autism Spectrum Disorder defined as “a) loss of both language and social skills or b) loss of either language or social skills” associated with some neuro-psychopathologies – such as intellectual impairment, seizures, ADHD, gastrointestinal, sleep concerns, Anxiety Disorders, depression and psychosis (schizophrenia) – has been controversial, poorly understood and mistreated (Hansen, et al, 2008; Tuchman, 2006.) The prevalence of developmental regression in autism is one of the more puzzling features of this disorder due to problems in the definition used. Individuals with regression performed significantly less well on communication than those without regression. A study which examined the prevalence of regressive autism found that 15% of autistic individuals lost both language and social skills and 41% lost either language or social skills (Hansen, et al, 2008.)
It is believed that environmental factors may have relevance to the regression as well as progressive degenerative disease of the brain. There are several hypotheses to explain autistic regression such as a slow viral infection, an autoimmune phenomenon, an insufficiency of growth factors during the development, abnormalities of an excitatory neurotransmitter and recurrent seizures or abnormal electrical activity in the brain. For instance, recurrent seizures can cause specific cognitive, language, or behavioral abnormalities. Seizures or the interictal epileptiform activity are responsible for the deterioration of the individual (Hrdlicka, 2008; Oslejsková, et al., 2008; Engel, et al., 2001; Deonna, 1991). The age of regression is higher in autistic individuals with seizures when compared to individuals with regression without epileptic seizures. Moreover, it has been observed that autistic regression has different clinical implications than individual with epilepsy (Danielsson, et al., 2005).
According to Tuchman and Rapin (1996), developmental regression occurred greater in individuals with autism and epileptiform EEG than in individual without epileptiform EEG. The clinical implications of regression in individuals with epilepsy are different from the clinical implications of regression with autism (Danielsson, 2005) In addition, in a case-control study, autism is more prevalent in individuals with Down syndrome than it does in the general population, and when autism is comorbid with Down Syndrome, regression in language and other skills, as measured by the Autism Diagnostic interview-Revised (ADI-R), are reported to occur in up to 50% of the cases (Castillo, et al., 2008). Individuals with autism and comorbid Fragile X, were found to be significantly more impaired in overall imitation abilities, oral-facial imitation, and imitations of actions and joint attention than individual without Fragile X (
Autism and regression represent a challenge from a pharmacological treatment point of view. The treatment should be designed accordingly with the features of regression. The pharmacological management would be different from the autism without regression. When autism with regression is suspected, clinicians should re-evaluate the comorbid conditions.
1) Tuberous sclerosis complex with autism, Leber’s congenital amaurosis, Coffin Siris, Biedl Bardet, Kleine Levin, Myhre, Apert, neuroaxonal dystrophy, HEADD, Klinefelter, San Filippo syndrome, Noonan, 10p deletion, etc.
1) Tuberous sclerosis complex
with autism, Leber’s congenital amaurosis, Coffin Siris, Biedl Bardet, Kleine Levin, Myhre,
Apert, neuroaxonal dystrophy, HEADD, Klinefelter, San Filippo syndrome, Noonan,
10p deletion, etc.
Zafeiriou, D., Ververi, A. and Vargiami, E. (2007). Childhood autism and associated comorbidities.