Autism regression is more common in Hispanic and Black children, study claims

A study claims that autism regresses more commonly in Hispanic and Black children than children of other races.

Autism spectrum disorders (ASDs) are a set of developmental disorders characterized by varying levels of social and communication problems. In a new study, researchers examined autistic children's likelihood of developmental regression, which occurs when children start to lose certain skills, such as talking, making eye contact and walking on schedule. The researchers found that black and Hispanic children appear to have a greater risk of regression than white children.

"Lost skills are very difficult to recover," said lead author Adiaha I. A. Spinks-Franklin, MD, MPH, FAAP, assistant professor of pediatrics at Baylor College of Medicine in Houston and associate director of the Developmental-Behavioral Pediatric Fellowship at Texas Children's Hospital. "Evidence suggests that African-American and Hispanic children are often diagnosed with autism at later ages than white children and have less access to services. Our research shows there is one more important factor that contributes to the developmental outcomes of African-American and Hispanic children with autism."

For this study, the researchers examined data on 1,353 autistic children who were a part of the Autism Speaks Autism Treatment Network database from March 2008 to December 2011. The data on the preschool children's demographics and medical information were collected at one of 17 locations throughout the U.S. and Canada.

The researchers found that 27 percent of the children went through developmental regression, which was reported by their parents. Based on these reports, the researchers calculated that black children were two times more likely to regress than white children. Hispanic children were 1.5 times more likely to regress than white children. The researchers found that these links exist even after accounting for the education levels of the children's primary caretaker and the children's insurance status

"We want parents to know that if they have any concerns about behavior or development patterns in their children - whether the concern is a loss of skills or some other type of concern - their child should be evaluated by a physician as soon as possible," said study co-author Jennifer B. Swanson, MD, FAAP, first-year developmental-behavioral pediatric fellow at Baylor College of Medicine, reported in the press release.

The study, "Racial Differences in Developmental Regression in Children with Autism Spectrum Disorders," was presented at the Pediatric Academic Societies (PAS) yearly meeting in Vancouver, British Columbia, Canada.

Read more here

Clinical characteristics of language regression in children.

This is a landmark article in looking at children with autistic regression. Seizures noted in 15% with regression. 61% had some recovery after seeing neurology
BUT 51% had developmental abnormalities BEFORE regression.
JR

Clinical characteristics of language regression in children

Wilson S, Djukic A, Shinnar S, Dharmani C, Rapin I.

Source

Saul R Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.

Dev Med Child Neurol. 2004 Dec;46(12):852.

Abstract

The spectrum of language regression in childhood is incompletely understood. To describe the features of this disorder more fully, we reviewed the records of 196 consecutive children (143 males and 53 females) with language regression or perceived plateau evaluated between 1988 and 1994 by a child neurologist. 

Mean age at regression was 21.2 months and the mean interval to referral was 34.8 months. 

A trigger for the regression was identified in 74 of the children (38%) and was associated with a more rapid regression. 

Mean age at follow-up was 64 months (SD 55). Seventy per cent of the children became nonverbal, and 75% were cognitively impaired. 

Language regression was associated with a more global autistic regression in 93% of children. 

There was a history of seizures in 15% of the children.

Some recovery occurred in 61% but only one child recovered fully. Improvement was more likely in the 49% who were entirely developmentally normal before the regression. 

We conclude that language regression in childhood is a serious disorder with significant long-term morbidity.

Dev Med Child Neurol. 2003 Aug;45(8):508-14.

When a child loses milestones, consider sleep EEG studies

Editor's Note: If a child has a regression, ask your doctor if a sleep EEG is approrpiate. JR

When a child loses milestones, consider sleep EEG studies

by NANCY FLIESLER on MAY 4, 2012

Excess brain electrical activity at night can disrupt development -- but if found, may be treatable.

This is the second post in a series about new approaches for seizures and epilepsy. 

When a 2- or 3-year-old child begins losing milestones like language, walking skills and fine motor abilities, or is slow to achieve them, it’s devastating for families. The good news, at least for some children, is that it might be treatable.

Tobias Loddenkemper, MD, a neurologist in theEpilepsy Center at Boston Children’s Hospital, suspected that some children with developmental delay have seizure-like activity in the brain at night. These spikes of electrical activity, referred to medically as sleep-potentiated epileptiform activity, can be readily and inexpensively detected by electroencephalography, or EEG, and readily treated with nighttime anti-seizure drugs.

But likely, no one’s thought of it. “Very few physicians have been looking to see what’s happening at night,” Loddenkemper says.

He and research fellow Iván Sánchez Fernández, MD, with other colleagues, decided to look themselves. They reviewed overnight EEG recordings from 147 patients who were seen at Boston Children’s over a 14-year period. They foundthat 100 of the 147 children indeed had prominent spikes in their EEGs during the night – and about one in five of them did not have known epilepsy.

Each wavy horizontal line on this child’s EEG shows electrical activity in different regions of the brain. Spiky triangular waves, like those highlighted in red, appear continuously during sleep, reflecting constant epileptic-like activity. Few such spikes were present in this child's daytime EEG.

“Kids can have an almost normal EEG while awake, but show increased spikes during sleep,” says Loddenkemper.

More here