Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, CA.
Department of Human Development and Family Studies, Purdue University, West Lafayette, IN.
Autism Res. 2018 May;11(5):788-797. doi: 10.1002/aur.1943. Epub 2018 Mar 10.
While previous studies suggested that regressive forms of onset were not common in autism spectrum disorder (ASD), more recent investigations suggest that the rates are quite high and may be under-reported using certain methods. The current study undertook a systematic investigation of how rates of regression differed by measurement method. Infants with (n = 147) and without a family history of ASD (n = 83) were seen prospectively for up to 7 visits in the first three years of life. Reports of symptom onset were collected using four measures that systematically varied the informant (examiner vs. parent), the decision type (categorical [regression absent or present] vs. dimensional [frequency of social behaviors]), and the timing of the assessment (retrospective vs. prospective). Latent class growth models were used to classify individual trajectories to see whether regressive onset patterns were infrequent or widespread within the ASD group. A majority of the sample was classified as having a regressive onset using either examiner (88%) or parent (69%) prospective dimensional ratings. Rates of regression were much lower using retrospective or categorical measures (from 29 to 47%). Agreement among different measurement methods was low. Declining trajectories of development, consistent with a regressive onset pattern, are common in children with ASD and may be more the rule than the exception. The accuracy of widely used methods of measuring onset is questionable and the present findings argue against their widespread use. Autism Res 2018, 11: 788-797. © 2018 International Society for Autism Research, Wiley Periodicals, Inc.
This study examines different ways of measuring the onset of symptoms in autism spectrum disorder (ASD). The present findings suggest that declining developmental skills, consistent with a regressive onset pattern, are common in children with ASD and may be more the rule than the exception. The results question the accuracy of widely used methods of measuring symptom onset and argue against their widespread use.
虽然先前的研究表明退行性发作形式在自闭症谱系障碍（ASD）中并不常见，但最近的研究表明，这些比率相当高，并且使用某些方法可能报告不足。本研究系统地调查了退行性发作的比率如何因测量方法而异。前瞻性地观察了 147 名有（n = 147）和 83 名无 ASD 家族史的婴儿（n = 83），在生命的头三年中最多进行了 7 次随访。使用四种测量方法收集了症状发作的报告，这些测量方法系统地改变了信息提供者（检查者与父母）、决策类型（分类[退行性发作存在或不存在]与维度[社交行为的频率]）以及评估的时间（回顾性与前瞻性）。使用潜在类别增长模型对个体轨迹进行分类，以确定退行性发作模式在 ASD 组中是否不常见或普遍。使用检查者（88%）或父母（69%）前瞻性维度评分，大多数样本被归类为具有退行性发作。使用回顾性或分类测量方法，退行的发生率要低得多（从 29%到 47%）。不同测量方法之间的一致性较低。与退行性发作模式一致的发育下降轨迹在 ASD 儿童中很常见，可能更常见而不是例外。广泛使用的发病测量方法的准确性值得怀疑，本研究结果反对广泛使用这些方法。自闭症研究 2018, 11: 788-797。© 2018 自闭症国际研究协会，威利期刊，公司。
本研究检查了自闭症谱系障碍（ASD）中测量症状发作的不同方法。本研究结果表明，与退行性发作模式一致的发育技能下降在 ASD 儿童中很常见，可能更常见而不是例外。研究结果对广泛使用的测量症状发作的方法的准确性提出了质疑，并反对广泛使用这些方法。
