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Clinical Pediatrics Apr 2004
Topics: Developmental Disabilities; Female; Food Hypersensitivity; Humans; Infant; Kwashiorkor; Regression, Psychology
PubMed: 15094960
DOI: 10.1177/000992280404300317 -
Journal of the American Psychoanalytic... Dec 2016The term regression refers to the idea that a person can return to earlier phases of mental development and the primitive modes of functioning associated with them. A...
The term regression refers to the idea that a person can return to earlier phases of mental development and the primitive modes of functioning associated with them. A core concept in both conflict and deficit models of development, the idea has nonetheless come under increasing scrutiny from critics who argue that it misleads us into a genetic fallacy whereby we reduce the issues of adolescent and adult development to their childhood precursors. Inderbitzen and Levy (2000) suggest that we focus on transformations, or shifts, in mental organization, instead of on regressions. But discarding the concept of regression has theoretical implications: to adopt instead a focus on shifts in mental organization we must (1) consider our object of study to be the meaning-making person, not isolated instincts or needs; (2) understand conscious and unconscious mental life to be embedded in the here-and-now relational field; and (3) adopt a lifespan model of development. The aim here is to outline a theoretical framework in which we can more fully explore the possibility of discarding "regression" in favor of a focus on transformations in the developmental present.
Topics: Adolescent; Adult; Child; Conflict, Psychological; Consciousness; Humans; Models, Psychological; Personality Development; Psychoanalytic Theory; Regression, Psychology; Unconscious, Psychology; Young Adult
PubMed: 28899146
DOI: 10.1177/0003065116679111 -
Italian Journal of Pediatrics Nov 2018Mucopolysaccharidoses (MPS) are a group of lysosomal multisystemic, chronic, and progressive diseases characterized by the storage of glycosaminoglycans (GAGs) that may... (Review)
Review
Mucopolysaccharidoses (MPS) are a group of lysosomal multisystemic, chronic, and progressive diseases characterized by the storage of glycosaminoglycans (GAGs) that may affect the central nervous system. Neuronopathic MPS such as MPS IH, MPS II, MPS IIIA-D, and MPS VII are characterized by neurocognitive regression. In severe MPS I (MPS IH, or Hurler syndrome) initial developmental trajectory is usually unremarkable but cognitive development shows a plateau by 2 to 4 years of age and then progressively regresses with aging. Patients with neuronopathic MPS II have a plateau of cognitive and adaptive development on average by 4 to 4.5 years of age, although there is significant variability, followed by progressive neurocognitive decline. In patients with classic MPS III, developmental trajectory reaches a plateau around 3 years of age, followed by regression. Sleep disturbances and behavioral problems occur early in MPS II and III with features of externalizing disorders. Acquired autism-like behavior is often observed in children with MPS III after 4-6 years of age. Impaired social and communication abilities do occur, but MPS III children do not have restricted and repetitive interests such as in autism spectrum disorder. MPS type VII is an ultra-rare neuronopathic MPS with a wide clinical spectrum from very severe with early mortality to milder phenotypes with longer survival into adolescence and adulthood. Most patients with MPS VII have intellectual disability and severely delayed speech development, usually associated with hearing impairment. Cognitive regression in neuronopathic MPS runs parallel to a significant decrease in brain tissue volume. Assessment of the developmental profile is challenging because of low cognitive abilities, physical impairment, and behavioral disturbances. Early diagnosis is crucial as different promising treatment approaches have been extensively studied in animal MPS models and are currently being applied in clinical trials.
Topics: Adolescent; Child; Child, Preschool; Humans; Mucopolysaccharidoses; Neurodevelopmental Disorders
PubMed: 30442188
DOI: 10.1186/s13052-018-0561-2 -
Psychoanalytic Review Apr 2010
Topics: Anxiety; Culture; Human Development; Humans; Paranoid Behavior; Psychoanalytic Theory; Psychology, Social; Regression, Psychology; Uncertainty
PubMed: 20406051
DOI: 10.1521/prev.2010.97.2.195 -
Developmental Science Mar 2016This article outlines the over-pruning hypothesis of autism. The hypothesis originates in a neurocomputational model of the regressive sub-type (Thomas, Knowland &... (Review)
Review
This article outlines the over-pruning hypothesis of autism. The hypothesis originates in a neurocomputational model of the regressive sub-type (Thomas, Knowland & Karmiloff-Smith, 2011a, 2011b). Here we develop a more general version of the over-pruning hypothesis to address heterogeneity in the timing of manifestation of ASD, including new computer simulations which reconcile the different observed developmental trajectories (early onset, late onset, regression) via a single underlying atypical mechanism; and which show how unaffected siblings of individuals with ASD may differ from controls either by inheriting a milder version of the pathological mechanism or by co-inheriting the risk factors without the pathological mechanism. The proposed atypical mechanism involves overly aggressive synaptic pruning in infancy and early childhood, an exaggeration of a normal phase of brain development. We show how the hypothesis generates novel predictions that differ from existing theories of ASD including that (1) the first few months of development in ASD will be indistinguishable from typical, and (2) the earliest atypicalities in ASD will be sensory and motor rather than social. Both predictions gain cautious support from emerging longitudinal studies of infants at-risk of ASD. We review evidence consistent with the over-pruning hypothesis, its relation to other current theories (including C. Frith's under-pruning proposal; C. Frith, 2003, 2004), as well as inconsistent data and current limitations. The hypothesis situates causal accounts of ASD within a framework of protective and risk factors (Newschaffer et al., 2012); clarifies different versions of the broader autism phenotype (i.e. the implication of observed similarities between individuals with autism and their family members); and integrates data from multiple disciplines, including behavioural studies, neuroscience studies, genetics, and intervention studies.
Topics: Autistic Disorder; Child; Child Development; Child, Preschool; Humans; Late Onset Disorders; Neuronal Plasticity; Phenotype; Regression, Psychology; Risk Factors; Siblings
PubMed: 25845529
DOI: 10.1111/desc.12303 -
Journal of Child Neurology Feb 2006Autistic spectrum disorders can be associated with mitochondrial dysfunction. We present a singleton case of developmental regression and oxidative phosphorylation...
Autistic spectrum disorders can be associated with mitochondrial dysfunction. We present a singleton case of developmental regression and oxidative phosphorylation disorder in a 19-month-old girl. Subtle abnormalities in the serum creatine kinase level, aspartate aminotransferase, and serum bicarbonate led us to perform a muscle biopsy, which showed type I myofiber atrophy, increased lipid content, and reduced cytochrome c oxidase activity. There were marked reductions in enzymatic activities for complex I and III. Complex IV (cytochrome c oxidase) activity was near the 5% confidence level. To determine the frequency of routine laboratory abnormalities in similar patients, we performed a retrospective study including 159 patients with autism (Diagnostic and Statistical Manual of Mental Disorders-IV and Childhood Autism Rating Scale) not previously diagnosed with metabolic disorders and 94 age-matched controls with other neurologic disorders. Aspartate aminotransferase was elevated in 38% of patients with autism compared with 15% of controls (P <.0001). The serum creatine kinase level also was abnormally elevated in 22 (47%) of 47 patients with autism. These data suggest that further metabolic evaluation is indicated in autistic patients and that defects of oxidative phosphorylation might be prevalent.
Topics: Aspartate Aminotransferases; Autistic Disorder; Biopsy; Child; Child, Preschool; Creatine Kinase; Cytochrome-c Oxidase Deficiency; Developmental Disabilities; Diagnosis, Differential; Electron Transport Complex I; Electron Transport Complex III; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Mitochondrial Diseases; Muscle, Skeletal; Muscular Atrophy; Regression, Psychology
PubMed: 16566887
DOI: 10.1177/08830738060210021401 -
Research in Developmental Disabilities Feb 2014Self injurious behaviors (SIBs) are challenging clinical problems in individuals with autism spectrum disorders (ASDs). This study is one of the first and largest to...
Self injurious behaviors (SIBs) are challenging clinical problems in individuals with autism spectrum disorders (ASDs). This study is one of the first and largest to utilize inpatient data to examine the associations between autism, developmental regression, and SIBs. Medical records of 125 neurobehavioral hospitalized patients with diagnoses of ASDs and SIBs between 4 and 17 years of age were reviewed. Data were collected from medical records on the type and frequency of SIBs and a history of language, social, or behavioral regression during development. The children with a history of any type of developmental regression (social, behavioral, or language) were more likely to have a diagnosis of autistic disorder than other ASD diagnoses. There were no significant differences in the occurrence of self injurious or other problem behaviors (such as aggression or disruption) between children with and without regression. Regression may influence the diagnostic considerations in ASDs but does not seem to influence the clinical phenotype with regard to behavioral issues. Additional data analyses explored the frequencies and subtypes of SIBs and other medical diagnoses in ASDs, with intellectual disability and disruptive behavior disorder found most commonly.
Topics: Adolescent; Autistic Disorder; Child; Child Development Disorders, Pervasive; Child, Preschool; Cohort Studies; Female; Humans; Intellectual Disability; Language; Logistic Models; Male; Odds Ratio; Regression, Psychology; Retrospective Studies; Self-Injurious Behavior; Social Behavior
PubMed: 24342713
DOI: 10.1016/j.ridd.2013.11.014 -
Ambulatory Pediatrics : the Official... 2008The aim of this study was to examine the prevalence of regressive autism and associated demographic, medical, and developmental factors by using 2 different definitions... (Comparative Study)
Comparative Study
OBJECTIVE
The aim of this study was to examine the prevalence of regressive autism and associated demographic, medical, and developmental factors by using 2 different definitions of regression based on the Autism Diagnostic Interview, Revised.
METHODS
Subjects were aged 2 to 5 years, with autism (AU) or autism spectrum disorder (ASD) confirmed by standardized measures. Children with regression, defined as a) loss of both language and social skills or b) loss of either language or social skills, were compared with each other and to children with AU or ASD with no reported loss of skills on developmental and adaptive functioning. Parents reported on seizure, gastrointestinal, and sleep concerns.
RESULTS
Fifteen percent (50/333) of the combined AU-ASD group lost both language and social skills; 41% (138/333) lost either language or social skills. No differences were found between the 2 samples of children with regression. Few developmental, demographic, or medical differences were found between the combined regression group and children without loss of skills, in both the larger AU-ASD sample and the more homogeneous AU-only sample. Children with regression had significantly lower communication scores than children without regression.
CONCLUSIONS
The prevalence of regression in a large sample of young children with AU and ASD varies depending on the definition used; requiring loss of language significantly underestimates the frequency of developmental regression. Children with regression performed significantly less well than those without regression on 2 measures of communication, but the clinical meaningfulness of these differences is uncertain because of the small effect sizes.
Topics: Adaptation, Psychological; Autistic Disorder; Child, Preschool; Female; Humans; Language Disorders; Male; Prevalence; Regression, Psychology; Social Behavior Disorders
PubMed: 18191778
DOI: 10.1016/j.ambp.2007.08.006 -
Clinical Pediatrics Jul 1986Loss of previously attained developmental milestones in an infant is often associated with central nervous system tumor, neuromuscular disease, or an inborn metabolic...
Loss of previously attained developmental milestones in an infant is often associated with central nervous system tumor, neuromuscular disease, or an inborn metabolic error. An infant with developmental regression and involuntary movements who was found to be vitamin B12 deficient on the basis of unrecognized maternal vitamin B12 deficiency is described. The infant had a dramatic neurologic recovery after receiving vitamin B12. The case and a review of similar cases is presented.
Topics: Anemia, Macrocytic; Breast Feeding; Developmental Disabilities; Fasciculation; Humans; Infant; Male; Movement Disorders; Regression, Psychology; Vitamin B 12 Deficiency
PubMed: 2423284
DOI: 10.1177/000992288602500708 -
Journal of Autism and Developmental... Dec 2004Information on age and nature of the onset of autism and other developmental disorders was obtained through review of parent completed developmental history; in addition...
Information on age and nature of the onset of autism and other developmental disorders was obtained through review of parent completed developmental history; in addition information on the child's early development, diagnostic information, and information on parent characteristics was also obtained. In this relatively large series of cases the parents of children with autism were more likely than parents of children with other developmental disorders to report possible loss of developmental skills. However, the question of actual skill loss was complicated since in some cases parents also had reported even earlier developmental delays or a pattern more of developmental stagnation than clear loss of abilities. Only a few children exhibited a clear and unequivocal loss of developmental skills.
Topics: Child; Child Development Disorders, Pervasive; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Male; Parents; Regression, Psychology; Surveys and Questionnaires
PubMed: 15679193
DOI: 10.1007/s10803-004-5294-y