Realities of Regression: Lessons Surrounding Developmental Regression in Children with Autism

What is Developmental Regression?

First, we must define what regression means in reference to neurodevelopmental disorders like Autism Spectrum Disorder. Regression is the loss or waning of previously developed skills. Skills that children with Autism need assistance in developing fall into these 4 groups: the socio-emotional, communication/linguistic, functional, and motor categories. 

Social and linguistic regression are the highest forms of regression reported to date, especially because language and social capabilities go hand in hand. Language regression is the gradual loss of certain vocalizations, and social regression is the lessening or changing of social behaviors. Social regression usually does not occur alone, it’s usually alongside linguistic regression (Backer, 2015). Lesser reported forms of regression include “mixed regression” which can refer to motor regression, general emotional regulation, or return/ increase in self-directed behaviors.

Where have we seen this?

As a pediatric clinical behavior technician, I have personally seen a few changes with my patients’ behaviors, the main one being linguistic and echoic decline. A few patients have made strides in language development during the summer and fall months, but have reverted to babbling or limiting their language. A good example of this is if a child has mastered positive and negative manding during the previous months (ie. “I want ice cream” and “I do not want to swim” respectively), but stopped being able to mand with full sentences months later (i.e. only say “wah-” or “want”). 

The interesting thing I have seen so far is that some children will exhibit a decline in full sentence development or social speech, but can still learn and build upon their vocabulary. It’s so impressive to see that some of my pediatric patients can still learn necessary items and words (mostly nouns i.e. “car” and “bowl”) to be able to communicate effectively, but can simultaneously be losing and limiting language for everyday social interactions. Some parents may view this as voluntary withdrawal or avoidance from socializing, but it’s important to recognize that even if there is a strong desire to communicate, it may be difficult to do so. Some other signs that you may notice are decreasing frequency in eye contact, reverting to sounds and actions naturally occurring in infancy (such as the babbling), or not understanding/ responding to statements that they understood in the past.

Why does Developmental Regression occur?

Developmental Regression can sometimes occur due to changes in their environment. More often than not, regression occurs during:

• Changing seasons
• Moving to new location
• Busier school seasons
• Highly social situations
• Change in family/ “safety net”

Regression can also occur during times of exhaustion or fatigue. At the home stretch of the year, almost everyone is tired from work and school, and it is totally understandable that there would be a decline in some of the skills they acquired throughout the year. It is also important that regression can be caused by a medical issue, such as a need for glasses or for ADHD diagnose/ medication, which I know can hinder learning and maintenance of skills from pas experience with my patients.

Should we be worried?

Growth and development are not linear processes so naturally there will sometimes be periods of regression. Developmental regression does not persist forever, and sometimes your child will take 4 steps forward and three steps back. I want to remind all of my parents: This is okay! Celebrate the small wins along the way and remember that this will pass; developmental regression is natural and reversible!

When should I seek outside support?

If you are still concerned about the regressive behavior and have questions about it, you can always ask your care team! Any of your child’s teachers, occupational therapists, speech-language pathologists, and/or BCBAs should be happy to help you through this period of regression. This is what your child’s safety net is for! You can also reach out to your doctors and Autism specialists for more support during this time.

I know for me, there are some days that I do a great job at work, and then there are other days where I am a bit slower with my response times or forget some details of certain protocols. That doesn't mean that there's anything wrong and I just work a little harder the next! The same goes for your kiddo; no one is perfect, and periods of regression or decline should be investigated, but also should be given some grace. You are doing a great job as a parent and I know that if you're reading this, your proactively looking for help and solutions for your child. Keep up the great work and continue encouraging your child to be the best they can be!

Thank you so much for reading my blog. If there are any questions, please feel free to put it in the comments or email me at theparentpartnertpp@gmail.com!