Regression in Autism: Prevalence and Associated Factors in the CHARGE Study

Hansen, Robin L.; Ozonoff, Sally; Krakowiak, Paula; Angkustsiri, Kathleen; Jones, Carrie; Deprey, Lesley J.; Le, Dung-Nghi; Croen, Lisa A.; Hertz-Picciotto, Irva

doi:10.1016/j.ambp.2007.08.006

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Volume 8, Issue 1 , Pages 25-31, January 2008

Regression in Autism: Prevalence and Associated Factors in the CHARGE Study

From the Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute, University of California, Davis, Sacramento, Calif (Dr Hansen, Dr Ozonoff, Ms Krakowiak, Dr Angkustsiri, Dr Jones, Dr Deprey, Ms Le, and Dr Hertz-Picciotto); Department of Pediatrics, School of Medicine, University of California, Davis, Sacramento, Calif (Dr Hansen and Dr Angkustsiri); Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, Sacramento, Calif (Dr Ozonoff); Division of Epidemiology, Department of Public Health Sciences, School of Medicine, University of California, Davis, Sacramento, Calif (Ms Krakowiak, Dr Jones, and Dr Hertz-Picciotto); and Division of Research, Kaiser Permanente Northern California, Oakland, Calif (Dr Croen)

Received 30 March 2007; accepted 28 August 2007.

Objective

The aim of this study was to examine the prevalence of regressive autism and associated demographic, medical, and developmental factors by using 2 different definitions of regression based on the Autism Diagnostic Interview, Revised.

Methods

Subjects were aged 2 to 5 years, with autism (AU) or autism spectrum disorder (ASD) confirmed by standardized measures. Children with regression, defined as a) loss of both language and social skills or b) loss of either language or social skills, were compared with each other and to children with AU or ASD with no reported loss of skills on developmental and adaptive functioning. Parents reported on seizure, gastrointestinal, and sleep concerns.

Results

Fifteen percent (50/333) of the combined AU-ASD group lost both language and social skills; 41% (138/333) lost either language or social skills. No differences were found between the 2 samples of children with regression. Few developmental, demographic, or medical differences were found between the combined regression group and children without loss of skills, in both the larger AU-ASD sample and the more homogeneous AU-only sample. Children with regression had significantly lower communication scores than children without regression.

Conclusions

The prevalence of regression in a large sample of young children with AU and ASD varies depending on the definition used; requiring loss of language significantly underestimates the frequency of developmental regression. Children with regression performed significantly less well than those without regression on 2 measures of communication, but the clinical meaningfulness of these differences is uncertain because of the small effect sizes.

Key Words: autism, onset, prevalence, regression