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Skill lag and loss common in children with autism

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Laura Geggel
7 January 2014

There are numerous reports of children with autism learning how to do something, such as wave goodbye, and then losing that skill abruptly weeks or months later. But there is little information about the exact age at which a new skill develops or disappears.

That may be because children with the disorder lose skills in no particular order, according to a study published 25 November in Development and Psychopathology.

The study asked parents of 244 children to recall whether and at what age their children gained or lost 15 interactive skills, including saying their first words and playing peek-a-boo.

Children with autism or autism-like traits are more likely than controls to have delays in skill development and tend to lose at least one skill as they go from infancy through early childhood, reports the study. Consequently, skill acquisition and loss in these children may best be viewed as a continuous process that begins with developmental delays and ends with disappearing skills, the researchers say.

The researchers looked at 125 children with autism, 42 with pervasive developmental disorder-not otherwise specified (now part of the autism diagnosis), 46 with developmental delays and 31 controls. They regarded a skill as lost if a child used it for at least a month before it vanished.

Only 5 percent of the autism group mastered all 15 skills, compared with 92 percent of the controls. They also acquired the skills later than controls, with the first differences appearing at 2 months of age. For example, 86 percent of the children with autism learned how to play peek-a-boo, but they learned it about one year later than the controls did.

About 76 percent of the autism group never learned to point and show an object to someone else, and about half never learned to wave goodbye.

The autism group also lost more skills. About 60 percent of the children with autism lost at least one skill, compared with 24 percent of the developmentally disabled group. Only one of the controls lost a skill — the use of words, the child’s parent reported.

The skill that children with autism lose most frequently is eye contact, followed by pointing to express an interest and waving goodbye. This regression typically happens between 9 months and 3 years of age, with 60 percent regressing by 18 months.

The number and type of skills gained and lost are all over the map: One child with autism gained and lost all 15 skills, whereas others learned several skills and lost only a few. This suggests that the gain and loss of skills occur independently.

News and Opinion articles on SFARI.org are editorially independent of the Simons Foundation.

Comments

Name: Martha Gabler
10 January 2014 - 8:26PM

This article notes that children with autism may lose skills they once had learned. The science of Applied Behavior Analysis provides answers to the question of how this happens. Skills in all children, but especially children with autism, must be properly reinforced, and the way to do this is well known. When learning a skill, the child should be reinforced every time he/she performs it; this is known as a “continuous reinforcement schedule.” To maintain a skill, the child should be reinforced at a variable rate; this is known as an “intermittent schedule.” With an intermittent schedule, a child who has acquired a skill will no longer be reinforced every time he/she performs it, but will be reinforced one out of every two times, two out of every three times, then two out of every five times, with longer intervals occurring between the episodes of reinforcement. An intermittent schedule is a powerful tool for maintaining behaviors. Children who lose skills are children who are being incorrectly or insufficiently reinforced. It is the result of poor training, not something intrinsic to the child. Luckily, the loss of skills can be reversed with proper reinforcement procedures in place, and proper monitoring and measuring to make sure that the child continues to learn.

Name: Patricia
12 January 2014 - 10:10PM

Has any research been done regarding the shots given at 16-18 month mark? My son regressed in many ways. His speech completely stopped and his eatingSq habits changed. He went from eating everything to starting all over. Textures are still a problem, but improving. I'm not saying the shots caused it, but they do accelerate symptoms and caused the regression. It's upsetting to hear doctors tell you that it has not been scientifically proven, when so many parents have witnessed this in their kids.

Name: Katie
14 January 2014 - 8:47PM

Unfortunately, skill loss cannot be reversed much of the time. If only! The cause of regression is clearly biological, not behavioral. My son lost 500 words and all motor skills within the course of a few months. We did e-v-e-r-y-t-h-i-n-g. Intermittent skills training and r-enforcement, ABA, speech OT with excellent providers, the best in the state. I trained in ABA as well. I have a MA in Education. Yet my 2 year old only got worse over time. Regression is often the result of encephalitis- brain inflammation. I did not give birth to a baby with autism, he acquired autism. After the 18 month mark he had an horrendous reaction to multitude of vaccines, febrile seizure, stopped eating for days, screamed nonstop for weeks....He has never regained his speech. Like the Mom above I am not saying it was all vaccines but that was a big problem. I am not looking to "blame something" I had a healthy baby on the way to the pediatrician's office and a hysterical, febrile baby in the back seat of my car on the ride home. He was never the same.

In retrospect I wish I had been able to fund a doctor who understood encephalitis and treated my son with anti-inflammatories or IVIG or at least knew about anti-NMDA receptor encephalitis. Only when a child is stable and healthy are they available for learning. I still believe in traditional behavioral interventions but we need to stop kidding ourselves, too many kids are not recovering because of untreated brain inflammation.

Name: Beth
15 January 2014 - 5:48AM

According to the author of "Disconnected Kids," Dr. Robert Melillo, who is also the founder of "Brain Balance Centers" in The U.S., skills are right brain left brain and dysfunction of kickoff of milestones is a result of out of sync Lt brain/Rt brain during newborn and up development. I credit this author for insight to look at my son's pediatric records earlier (2 months) rather than later (12 plus months to 16 months) when autism was more obvious by loss of skill, speech, pointing & acquired weakness-motor skills loss. Ironically, my son started suffering from asthma, RSV, ear infections after his 2 month immunizations. Every time he was vaccinated the who reactive process started again with the asthma, eczema, RSV & ear infections. My son has tested positive for MTHFR & had I known his body does not tolerate the components of vaccine, I would have spaced his vaccines out. The point I'm making is that developmental issues start from birth and when that body/brain connection gets skewed by autoimmune response, process, the motor milestones can be affected. When higher level functioning is required as the child ages, the brain can still be out of sync leading to functional delays.

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