Goldberg Wendy A, Osann Kathy, Filipek Pauline A, Laulhere Tracy, Jarvis Kelly, Modahl Charlotte, Flodman Pamela, Spence M Anne
Department of Psychology and Social Behavior, University of California, Irvine, Irvine, California, USA.
J Autism Dev Disord. 2003 Dec;33(6):607-16. doi: 10.1023/b:jadd.0000005998.47370.ef.
Understanding of regression in autism has been hampered by variability in parental and clinical recognition and reporting of lost skills. This study introduced an instrument, the Regression Supplement Form, intended to supplement the Autism Diagnosis Interview-Revised and yield precise information about the types and timing of regression and events concurrent with loss and regain of skills. Data were collected from parents of 44 children (38 male, 6 female; mean age = 6 years) with Autistic Spectrum Disorder (37 Autistic Disorder, 7 Pervasive Developmental Disorder-Not Otherwise Specified). Parental responses on the Autism Diagnosis Interview-Revised indicated loss of skills during early development. The profile of regression that emerged included loss of skills between 18 and 21 months, on average, with language-only regression less common than loss of other, nonlanguage skills only or of full regression (loss of language and other skills). The onset of regression typically was gradual in nonlanguage areas and split between gradual and sudden loss for language skills. Some of the children were developing atypically before they lost other, nonlanguage skills, that is, their age at first words was delayed until age 2 years or older. Parents tended to attribute loss to medical factors such as immunizations. Many of the children regained some of the lost skills when they were 3.5-5 years of age, with therapeutic and instructional interventions given credit for the regain.
自闭症患者技能退化的相关情况一直因家长和临床医生在对已丧失技能的识别与报告方面存在差异而受到阻碍。本研究引入了一种工具,即《退化补充表》,旨在补充《自闭症诊断访谈修订版》,并获取有关技能退化的类型、时间以及技能丧失和恢复时伴随事件的精确信息。研究数据收集自44名患有自闭症谱系障碍(37名自闭症障碍患者,7名未另行分类的广泛性发育障碍患者)儿童(38名男性,6名女性;平均年龄 = 6岁)的家长。家长在《自闭症诊断访谈修订版》中的回答表明,孩子在早期发育过程中出现了技能丧失。所呈现的退化情况包括,平均而言,在18至21个月大时出现技能丧失,仅语言技能退化的情况比仅丧失其他非语言技能或全面退化(语言和其他技能均丧失)的情况少见。退化的开始在非语言领域通常较为渐进,而语言技能的退化则在渐进性丧失和突然丧失之间有所不同。一些孩子在丧失其他非语言技能之前发育就不正常,也就是说,他们说出第一个单词的年龄延迟到2岁或更大。家长往往将技能丧失归因于诸如免疫接种等医学因素。许多孩子在3.5至5岁时恢复了一些丧失的技能,恢复被归功于治疗和教育干预。