Validation of the phenomenon of autistic regression using home videotapes.

CONTEXT To date, there has been no objective validation of the phenomenon of autistic regression early in life. OBJECTIVE To validate parental report of autistic regression using behavioral data coded from home videotapes of children with autism spectrum disorder (ASD) vs typical development taken at 12 and 24 months of age. DESIGN Home videotapes of 56 children's first and second birthday parties were collected from parents of young children with ASD with and without a reported history of regression and typically developing children. Child behaviors were coded by raters blind to child diagnosis and regression history. A parent interview that elicited information about parents' recall of early symptoms from birth was also administered. SETTING Participants were recruited from a multidisciplinary study of autism conducted at a major university. PARTICIPANTS Fifteen children with ASD with a history of regression, 21 children with ASD with early-onset autism, and 20 typically developing children and their parents participated. MAIN OUTCOME MEASURES Observations of children's communicative, social, affective, repetitive behaviors, and toy play coded from videotapes of the toddlers' first and second birthday parties. RESULTS Analyses revealed that infants with ASD with regression show similar use of joint attention and more frequent use of words and babble compared with typical infants at 12 months of age. In contrast, infants with ASD with early onset of symptoms and no regression displayed fewer joint attention and communicative behaviors at 12 months of age. By 24 months of age, both groups of toddlers with ASD displayed fewer instances of word use, vocalizations, declarative pointing, social gaze, and orienting to name as compared with typically developing 24-month-olds. Parent interview data suggested that some children with regression displayed difficulties in regulatory behavior before the regression occurred. CONCLUSION This study validates the existence of early autistic regression.