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Bayonet-shaped language development in autism with regression: a retrospective study
BACKGROUND: Language delay is one of the major referral criteria for an autism evaluation. Once an autism spectrum diagnosis is established, the language prognosis is among the main parental concerns. Early language regression (ELR) is observed by 10–50% of parents but its relevance to late language...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117564/ https://www.ncbi.nlm.nih.gov/pubmed/33985558 http://dx.doi.org/10.1186/s13229-021-00444-8 |
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author | Gagnon, David Zeribi, Abderrahim Douard, Élise Courchesne, Valérie Rodríguez-Herreros, Borja Huguet, Guillaume Jacquemont, Sébastien Loum, Mor Absa Mottron, Laurent |
author_facet | Gagnon, David Zeribi, Abderrahim Douard, Élise Courchesne, Valérie Rodríguez-Herreros, Borja Huguet, Guillaume Jacquemont, Sébastien Loum, Mor Absa Mottron, Laurent |
author_sort | Gagnon, David |
collection | PubMed |
description | BACKGROUND: Language delay is one of the major referral criteria for an autism evaluation. Once an autism spectrum diagnosis is established, the language prognosis is among the main parental concerns. Early language regression (ELR) is observed by 10–50% of parents but its relevance to late language level and socio-communicative ability is uncertain. This study aimed to establish the predictive value of ELR on the progression of language development and socio-communicative outcomes to guide clinicians in addressing parents’ concerns at the time of diagnosis. METHODS: We used socio-communicative, language, and cognitive data of 2,047 autism spectrum participants from the Simons Simplex Collection, aged 4–18 years (mean = 9 years; SD = 3.6). Cox proportional hazard and logistic regression models were used to evaluate the effect of ELR on language milestones and the probability of using complex and flexible language, as defined by the choice of ADOS module at enrollment. Linear models were then used to evaluate the relationship of ELR and non-verbal IQ with socio-communicative and language levels. RESULTS: ELR is associated with earlier language milestones but delayed attainment of fluent, complex, and flexible language. However, this language outcome can be expected for almost all autistic children without intellectual disability at 18 years of age. It is mostly influenced by non-verbal IQ, not ELR. The language and socio-communicative level of participants with flexible language, as measured by the Vineland and ADOS socio-communicative subscales, was not affected by ELR. LIMITATIONS: This study is based on a relatively coarse measure of ultimate language level and relies on retrospective reporting of early language milestones and ELR. It does not prospectively document the age at which language catches up, the relationship between ELR and other behavioral areas of regression, nor the effects of intervention. CONCLUSIONS: For autistic individuals with ELR and a normal level of non-verbal intelligence, language development follows a “bayonet shape” trajectory: early first words followed by regression, a plateau with limited progress, and then language catch up. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13229-021-00444-8. |
format | Online Article Text |
id | pubmed-8117564 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-81175642021-05-13 Bayonet-shaped language development in autism with regression: a retrospective study Gagnon, David Zeribi, Abderrahim Douard, Élise Courchesne, Valérie Rodríguez-Herreros, Borja Huguet, Guillaume Jacquemont, Sébastien Loum, Mor Absa Mottron, Laurent Mol Autism Research BACKGROUND: Language delay is one of the major referral criteria for an autism evaluation. Once an autism spectrum diagnosis is established, the language prognosis is among the main parental concerns. Early language regression (ELR) is observed by 10–50% of parents but its relevance to late language level and socio-communicative ability is uncertain. This study aimed to establish the predictive value of ELR on the progression of language development and socio-communicative outcomes to guide clinicians in addressing parents’ concerns at the time of diagnosis. METHODS: We used socio-communicative, language, and cognitive data of 2,047 autism spectrum participants from the Simons Simplex Collection, aged 4–18 years (mean = 9 years; SD = 3.6). Cox proportional hazard and logistic regression models were used to evaluate the effect of ELR on language milestones and the probability of using complex and flexible language, as defined by the choice of ADOS module at enrollment. Linear models were then used to evaluate the relationship of ELR and non-verbal IQ with socio-communicative and language levels. RESULTS: ELR is associated with earlier language milestones but delayed attainment of fluent, complex, and flexible language. However, this language outcome can be expected for almost all autistic children without intellectual disability at 18 years of age. It is mostly influenced by non-verbal IQ, not ELR. The language and socio-communicative level of participants with flexible language, as measured by the Vineland and ADOS socio-communicative subscales, was not affected by ELR. LIMITATIONS: This study is based on a relatively coarse measure of ultimate language level and relies on retrospective reporting of early language milestones and ELR. It does not prospectively document the age at which language catches up, the relationship between ELR and other behavioral areas of regression, nor the effects of intervention. CONCLUSIONS: For autistic individuals with ELR and a normal level of non-verbal intelligence, language development follows a “bayonet shape” trajectory: early first words followed by regression, a plateau with limited progress, and then language catch up. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13229-021-00444-8. BioMed Central 2021-05-13 /pmc/articles/PMC8117564/ /pubmed/33985558 http://dx.doi.org/10.1186/s13229-021-00444-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Gagnon, David Zeribi, Abderrahim Douard, Élise Courchesne, Valérie Rodríguez-Herreros, Borja Huguet, Guillaume Jacquemont, Sébastien Loum, Mor Absa Mottron, Laurent Bayonet-shaped language development in autism with regression: a retrospective study |
title | Bayonet-shaped language development in autism with regression: a retrospective study |
title_full | Bayonet-shaped language development in autism with regression: a retrospective study |
title_fullStr | Bayonet-shaped language development in autism with regression: a retrospective study |
title_full_unstemmed | Bayonet-shaped language development in autism with regression: a retrospective study |
title_short | Bayonet-shaped language development in autism with regression: a retrospective study |
title_sort | bayonet-shaped language development in autism with regression: a retrospective study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117564/ https://www.ncbi.nlm.nih.gov/pubmed/33985558 http://dx.doi.org/10.1186/s13229-021-00444-8 |
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