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Cortex; a Journal Devoted To the Study... Dec 2023Developmental regression describes when a child loses previously established skills, such as the ability to speak words and is most recognised in neurodevelopmental... (Review)
Review
Developmental regression describes when a child loses previously established skills, such as the ability to speak words and is most recognised in neurodevelopmental conditions including Autism; Developmental Epileptic Encephalopathies, such as Landau Kleffner syndrome, and genetic conditions such as Rett syndrome and Phelan McDermid syndrome. Although studies have reported developmental regression for over 100 years, there remain significant knowledge gaps within and between conditions that feature developmental regression. The certainty of evidence from earlier work has been limited by condition-specific studies, retrospective methodology, and inconsistency in the definitions and measures used for classification. Given prior limitations in the field, there is a paucity of knowledge about neurocognitive mechanisms, trajectories and outcomes for children with developmental regression, and their families. Here we provide a comprehensive overview, synthesise key definitions, clinical measures, and aetiological clues associated with developmental regression and discuss impacts on caregiver physical and mental health to clarify challenges and highlight future directions in the field.
Topics: Child; Humans; Retrospective Studies; Autistic Disorder; Epilepsy; Epilepsy, Generalized
PubMed: 37839389
DOI: 10.1016/j.cortex.2023.09.001 -
Mental Retardation and Developmental... 2004The occurrence of developmental regression in autism is one of the more puzzling features of this disorder. Although several studies have documented the validity of... (Review)
Review
The occurrence of developmental regression in autism is one of the more puzzling features of this disorder. Although several studies have documented the validity of parental reports of regression using home videos, accumulating data suggest that most children who demonstrate regression also demonstrated previous, subtle, developmental differences. Counter to clinical intuition, the earlier development of social, language, and attachment behaviors followed by regression does not seem to support later recovery of skills or better developmental outcomes compared to children who never had speech or typical social responsivity. In fact, this regressive group may have somewhat greater developmental impairment than the nonregressive group, though the two groups do not appear to present different behavioral phenotypes. Although autism is not the only condition in which regression occurs, it appears to be the most frequent condition. Other disorders that demonstrate an early regression with no known etiology include total blindness from birth and childhood disintegrative disorder, both of which demonstrate behavioral relations to autism. In addition, two biological conditions with known etiologies also involve regression with some behaviors resembling autism behavioral phenotype: Rett syndrome (a genetic disorder; see Glaze, this issue) and Landau-Kleffner syndrome (see McVicar and Shinnar, this issue), which involves a seizure disorder.
Topics: Age Factors; Autistic Disorder; Child; Child Behavior Disorders; Humans; Infant; Language Disorders; Object Attachment; Regression, Psychology; Social Behavior
PubMed: 15362172
DOI: 10.1002/mrdd.20027 -
Neuroscience and Biobehavioral Reviews Dec 2019
Topics: Consensus; Humans; Regression, Psychology
PubMed: 31442516
DOI: 10.1016/j.neubiorev.2019.08.014 -
Pediatrics Jun 2020Down syndrome disintegrative disorder (DSDD), a developmental regression in children with Down syndrome (DS), is a clinical entity that is characterized by a loss of... (Review)
Review
Down syndrome disintegrative disorder (DSDD), a developmental regression in children with Down syndrome (DS), is a clinical entity that is characterized by a loss of previously acquired adaptive, cognitive, and social functioning in persons with DS usually in adolescence to early adulthood. Initially reported in 1946 as "catatonic psychosis," there has been an increasing interest among the DS community, primary care, and subspecialty providers in this clinical area over the past decade. This condition has a subacute onset and can include symptoms of mood lability, decreased participation in activities of daily living, new-onset insomnia, social withdrawal, autistic-like regression, mutism, and catatonia. The acute phase is followed by a chronic phase in which baseline functioning may not return. No strict criteria or definitive testing is currently available to diagnose DSDD, although a comprehensive psychosocial and medical evaluation is warranted for individuals presenting with such symptoms. The etiology of DSDD is unknown, but in several hypotheses for regression in this population, psychological stress, primary psychiatric disease, and autoimmunity are proposed as potential causes of DSDD. Both psychiatric therapy and immunotherapies have been described as DSDD treatments, with both revealing potential benefit in limited cohorts. In this article, we review the current data regarding clinical phenotypes, differential diagnosis, neurodiagnostic workup, and potential therapeutic options for this unique, most disturbing, and infrequently reported disorder.
Topics: Activities of Daily Living; Adolescent; Autistic Disorder; Catatonia; Child; Developmental Disabilities; Down Syndrome; Female; Humans; Male; Mood Disorders; Psychotic Disorders; Review Literature as Topic
PubMed: 32471843
DOI: 10.1542/peds.2019-2939 -
Journal of Developmental and Behavioral... Sep 2022Unexplained regression in Down syndrome (URDS) involves a loss of acquired skills resulting in functional deterioration. Despite extensive workup and treatment, few...
OBJECTIVE
Unexplained regression in Down syndrome (URDS) involves a loss of acquired skills resulting in functional deterioration. Despite extensive workup and treatment, few individuals regain baseline function. This study aimed to understand the role of psychosocial stressors in URDS.
METHODS
We describe psychosocial stressors in 14 cases of URDS. Specifically, we examined psychosocial stressors in the context of presentation and clinical symptoms. We also examined co-occurring neurodevelopmental disorders and medical and mental health conditions.
RESULTS
All individuals experienced psychosocial stressors within one year of diagnosis of URDS. The most common psychosocial stressors were moving to a new home or school.
CONCLUSION
Psychosocial stressors are commonly reported preceding URDS. Knowledge about psychosocial stressors' impact may lead to preventive interventions, improved monitoring, and earlier diagnosis. Future research should focus on understanding psychosocial stressors to help identify individuals at risk for URDS and contribute to treatment.
Topics: Down Syndrome; Humans; Mental Disorders; Stress, Psychological
PubMed: 35943343
DOI: 10.1097/DBP.0000000000001086 -
Neuroscience and Biobehavioral Reviews Jan 2019Regression in children with epilepsy may involve loss of cognitive abilities, failure to progress or a slowing of developmental trajectory. A few seizures do not lead to... (Review)
Review
Regression in children with epilepsy may involve loss of cognitive abilities, failure to progress or a slowing of developmental trajectory. A few seizures do not lead to regression. Large numbers of seizures may be associated with regression but the cause is an important cofounder. Individual spike discharges on EEG are associated with transient cognitive impairment and continuous spike discharges with regression. Regression may be global in continuous spike wave in slow sleep (CSWS) or specific (auditory agnosia) in Landau Kleffner syndrome. Regression is mild and transient in Rolandic Epilepsy or profound and permanent in West Syndrome. Epilepsy syndromes grouped under "epileptic encephalopathies" may lead to regression, although proof of this concept is not strong for many syndromes. The absence of cognitive assessment before epilepsy onset, the contribution of the cause and complications of treatment make for difficult methodological problems. The large majority of children with epilepsy do not have regression. There is need for more longitudinal studies of children with epileptic encephalopathies and other epilepsies associated with regression.
Topics: Animals; Brain; Child; Epilepsy; Humans
PubMed: 30537476
DOI: 10.1016/j.neubiorev.2018.12.008 -
Journal of Autism and Developmental... Apr 2000Developmental regression among children with autism is a common phenomenon of unknown origin. The purpose of this study was to identify the differences between children...
Developmental regression among children with autism is a common phenomenon of unknown origin. The purpose of this study was to identify the differences between children with autism who reportedly regressed with those who did not regress. A representative group of 39 mothers were interviewed (40 children--1 pair of twin girls) about familial, pregnancy, perinatal, as well as medical history and developmental milestones. The study focused on mothers' perceptions of developmental regression. Nineteen children (47.5%) regressed in verbal and nonverbal communication and social but not in motor abilities. Mean age of regression was 24 months, with 11 children who regressed before and 8 after this age. No significant differences were reported by mothers of children who did or did not regress. More mothers of children who regressed, than those of children who did not, expressed guilt feelings regarding the development of autism, and almost all of them had an "explanation" for the possible mechanisms that might have influenced their children's developmental course. In conclusion, developmental regression in our population appears to be a typical event in the natural course of autism. There is little difference between those children who regressed and those who did not regress in maternal perceptions and reports of development, family, and medical history.
Topics: Autistic Disorder; Child; Developmental Disabilities; Diseases in Twins; Female; Humans; Male; Mothers; Personality Assessment; Pregnancy; Prenatal Exposure Delayed Effects; Regression, Psychology; Risk Factors
PubMed: 10832775
DOI: 10.1023/a:1005403421141 -
Archives of Disease in Childhood Nov 2008
Review
Topics: Autistic Disorder; Child, Preschool; Developmental Disabilities; Electroencephalography; Epilepsy; Evidence-Based Medicine; Humans; Male; Unnecessary Procedures
PubMed: 18941024
DOI: 10.1136/adc.2008.137273 -
Acta Medica Iranica Feb 2017While studies have shown the disastrous effects of post-partum depression (PPD) on children's behaviors, there is relatively lack of reliable data in Asian countries....
While studies have shown the disastrous effects of post-partum depression (PPD) on children's behaviors, there is relatively lack of reliable data in Asian countries. This study examined the relative significance of maternal PPD in children's developmental disabilities at age four. In a longitudinal study design (2009), 1801 pregnant women attending in primary health centers of Mazandaran province in the north of Iran provided self-reports of depression from two to twelve postpartum weeks using Edinburgh Postnatal Depression Scale (EPDS). Approximately four years later, the women experiencing PPD and twice as the ones who did not experience this disorder were considered as case (N=204) and control (N=467) groups. The association between maternal depression at different times and childhood developmental disabilities based on Ages and Stages Questionnaire (ASQ) and other health problems reported by the child were analyzed using two-sample t-test, chi-square test, and logistic regression models. The presence of PPD only was not a predictor of child's developmental disabilities at age four. Childhood developmental disabilities in communication, gross motor and personal-social domains of ASQ were associated with the current and concurrent maternal depressive symptoms (OR=2.59, 95% CI=1.16-5.78; OR=4.34, 95% CI=2.10-8.96; OR=5.66, 95% CI=1.94-16.54 and OR=3.35, 95% CI=1.31-8.58; OR=4.15, 95% CI=2.72-13.87; OR=6.17, 95% CI=1.95-19.53 respectively). PPD, the current depressive symptoms, and depression at both occasions were associated with more health problems in children. Childhood developmental disabilities in some domains of ASQ were significantly related to the maternal depression chronicity or recurrence. Also, child's difficulties were more prevalent in association with maternal depression regardless of onset time.
Topics: Adult; Child Behavior; Child Development; Child Health; Child, Preschool; Communication; Depression, Postpartum; Developmental Disabilities; Female; Humans; Iran; Longitudinal Studies; Motor Skills; Pregnancy; Prevalence; Psychiatric Status Rating Scales; Regression Analysis; Surveys and Questionnaires
PubMed: 28282707
DOI: No ID Found -
Journal of Paediatrics and Child Health Jan 2015Since the Journal of Paediatrics and Child Health was first published, there has been substantial change in the field of autism spectrum disorders (ASDs) with an... (Review)
Review
Since the Journal of Paediatrics and Child Health was first published, there has been substantial change in the field of autism spectrum disorders (ASDs) with an exponential increase in the amount of funded and published research. In this paper, we focus on regression in children with ASD, a phenomenon that remains poorly understood. We discuss the implications of what we know about regression in ASD for the way we think about ASD more broadly and for paediatric practice.
Topics: Child; Child Development; Child Development Disorders, Pervasive; Child, Preschool; Disease Progression; Humans; Prognosis
PubMed: 25586846
DOI: 10.1111/jpc.12805