Possible pubertal effect on therapeutic gains in an autistic girl.

A deaf, partially sighted, severely retarded autistic girl, 11 years, 6 months of age, received approximately 2 years of occupational therapy, where sensory integration procedures were employed to reduce self-stimulation. Videotaped time samples of the amount of stereotypies showed a consistent reduction from the time of starting therapy to an interruption for vacation and surgery for scoliosis 46 weeks later. On returning to therapy after a 9-week break, self-stimulation had greatly increased and did not return to the presurgery level during an additional 55 weeks of therapy, 30 of which followed the removal of a cast. Menarche occurred 1 week after removing the cast. Increased self-stimulation is linked to reduced inclination toward environmental interaction as well as to an interruption of intervention and possible pubertal effect. Brief reports on four other autistic adolescents who received similar therapy are consistent with the conjecture of frequent pubertal regression.