Abstract
Background: Language regression, broadly defined as the loss of acquired language skills in early childhood, is a distinctive feature of autism. Little is known about the factors underlying regression or the prognosis of children who exhibit regression. We examine potential predictors of language regression and test its association with language development in a prospective longitudinal sample of children with autism spectrum disorder (ASD) from diagnosis to age 10 years.
Methods: We analysed data from Pathways in ASD, a prospective longitudinal study of 421 children enrolled around the time of an autism diagnosis between 2 and 5 years. Autism Diagnostic Interview-Revised data were available for 408 children, of whom 90 (22%) were classified as having language regression.
Results: Demographic and other health factors including caregiver education, family income, child sex, reported seizures, and age of enrolment did not differ between children with and without language regression. Children with language regression walked earlier and attained first words sooner than those without regression. However, both groups attained phrase speech at comparable ages. Those with regression exhibited greater delays in expressive and receptive communication over the follow-up period, although this effect was attenuated when accounting for baseline differences in motor and cognitive ability. Overall, those with language regression continued to exhibit expressive but not receptive communication delay compared to those without regression. Communication trajectories were heterogeneous to age 10 years, irrespective of regression status.
Conclusions: Although language regression can be alarming, our findings confirm that its occurrence does not necessarily foreshadow worse developmental outcomes relative to those without regression. Although a discrepancy in age-equivalent communication skills may persist, this can be expected to be of less practical importance with rising average levels of skills. Future studies need to account for the significant variability in language trajectories by considering factors beyond developmental regression.
Original language | English |
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Pages (from-to) | 1243-1251 |
Number of pages | 9 |
Journal | Journal of Child Psychology and Psychiatry |
Volume | 63 |
Issue number | 11 |
DOIs | |
Publication status | Published - 30 Jan 2022 |
Bibliographical note
Funding Information:The authors acknowledge funding by The Canadian Institutes of Health Research, Fonds de Recherche du Québec, Kids Brain Health Network (formerly NeuroDevNet), Autism Speaks (US), Government of British Columbia, Alberta Innovates Health Solutions, and the Sinneave Family Foundation. The authors also thank all the families who participated in the Pathways in ASD study. A.P. received additional support from the NIHR KCL/South London and Maudsley NHS Foundation Trust Biomedical Research Centre and Senior Investigator Award NF-SI-0617-10120. R.B. was supported by a King’s Prize Fellowship (204823/Z/16/Z). The authors also acknowledge the past and current members of the Pathways in ASD Study Team. Data sharing: Due to ethical constraints supporting data cannot be made openly available. Supporting data are available to bona fide researchers on approval of an application for access. Further information about the data and conditions for access can be obtained by contacting the PI Dr. Peter Szatmari ([email protected]). The authors have declared that they have no competing or potential conflicts of interest.Key points Evidence on the predictors of and outcomes from language regression has been mixed. In a prospective study of children with autism assessed from diagnosis (at age 2–5 years) to age 10 years, we showed that language regression had a lasting association with lower expressive but not receptive communication skills. There was significant variability in language development in children both with and without regression, and both groups attained phrase speech at comparable ages. Early cognitive and motor skills were associated with regression and with later communication skills. We conclude that while language regression is associated with an age-equivalent delay in expressive communication, this may be of less practical importance with rising average level of skills. Evidence on the predictors of and outcomes from language regression has been mixed. In a prospective study of children with autism assessed from diagnosis (at age 2–5 years) to age 10 years, we showed that language regression had a lasting association with lower expressive but not receptive communication skills. There was significant variability in language development in children both with and without regression, and both groups attained phrase speech at comparable ages. Early cognitive and motor skills were associated with regression and with later communication skills. We conclude that while language regression is associated with an age-equivalent delay in expressive communication, this may be of less practical importance with rising average level of skills.
Publisher Copyright:
© 2022 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.
Keywords
- Language
- autism
- development
ASJC Scopus subject areas
- Psychiatry and Mental health
- Developmental and Educational Psychology
- Pediatrics, Perinatology, and Child Health