Bradley Catherine C, Boan Andrea D, Cohen Amy P, Charles Jane M, Carpenter Laura A
*Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Medical University of South Carolina, Charleston, SC; †Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC; ‡Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL.
J Dev Behav Pediatr. 2016 Jul-Aug;37(6):451-6. doi: 10.1097/DBP.0000000000000316.
Previous research on developmental regression in youth with autism spectrum disorders (ASD) has often been limited by the definition, assessment, and methodology used to evaluate and describe regression. This study sought to overcome these limitations by examining the prevalence, timing, and correlates of documented cases of developmental regression in a large, epidemiological sample of youth with ASD.
Utilizing a population-based surveillance methodology, this study includes 862 youth with ASD identified through abstraction and clinician record review.
Approximately 21% of the sample had developmental regression documented in their medical or educational records with the mean age of regression being 24.2 ± 14.3 months. Youth with ASD and a history of regression were more likely to have comorbid intellectual disability, a prior community diagnosis of ASD, and be eligible for educational services as a student with autism. Youth with a documented history of regression also had higher rates of restricted, repetitive behaviors, such as stereotyped speech, nonfunctional routines/rituals, and sensory interests.
Results suggest that youth with a history of regression are not only more likely to have comorbid intellectual disability but are also are more likely to have been previously diagnosed with ASD in the community, suggesting that development regression may play an important role in identifying children who are at the risk for ASD and need evaluation. Higher rates of restricted, repetitive behaviors in youth with a documented history of regression may also provide important insights into the relationship between ASD and developmental regression.
以往关于自闭症谱系障碍（ASD）青少年发育倒退的研究常常受到用于评估和描述倒退的定义、评估方法及方法论的限制。本研究旨在通过调查一个大型ASD青少年流行病学样本中已记录的发育倒退病例的患病率、发生时间及相关因素，来克服这些限制。
本研究采用基于人群的监测方法，纳入了通过摘要提取和临床医生记录审查确定的862名ASD青少年。
约21%的样本在其医疗或教育记录中有发育倒退的记录，倒退的平均年龄为24.2±14.3个月。有发育倒退史的ASD青少年更有可能合并智力残疾、先前在社区被诊断为ASD，并有资格作为自闭症学生接受教育服务。有记录的发育倒退史的青少年还具有更高比例的受限、重复行为，如刻板言语、无功能的日常活动/仪式和感官兴趣。
结果表明，有发育倒退史的青少年不仅更有可能合并智力残疾，而且更有可能先前在社区被诊断为ASD，这表明发育倒退可能在识别有ASD风险且需要评估的儿童方面发挥重要作用。有记录的发育倒退史的青少年中较高比例的受限、重复行为也可能为ASD与发育倒退之间的关系提供重要见解。
