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. 2022 Nov;63(11):1243-1251.
doi: 10.1111/jcpp.13565. Epub 2022 Jan 30.

Predictors of language regression and its association with subsequent communication development in children with autism

Andrew Pickles  1 , Nicola Wright  1 , Rachael Bedford  2 , Mandy Steiman  3 , Eric Duku  4 , Teresa Bennett  4 , Stelios Georgiades  4 , Connor M Kerns  5 , Pat Mirenda  5 , Isabel M Smith  6 , Wendy J Ungar  7 , Tracy Vaillancourt  8 , Charlotte Waddell  5 , Anat Zaidman-Zait  9 , Lonnie Zwaigenbaum  10 , Peter Szatmari  7 , Mayada Elsabbagh  3 ; Pathways in ASD Study Team
Affiliations

Predictors of language regression and its association with subsequent communication development in children with autism

Andrew Pickles et al. J Child Psychol Psychiatry. 2022 Nov.

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.

Keywords: Language; autism; development.

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Figures

Figure 1
Figure 1
Proportion yet to achieve milestones by age and loss group
Figure 2
Figure 2
Individual and group mean trajectories of parent‐reported expressive and receptive communication
See this image and copyright information in PMC

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