Regression in Autism—Not Just For Toddlers
I have done a lot of recent research on the facts of regression in autism, and I have come across a lot of articles covering regression in the toddler years. For many children affected with autism, this period of regression is usually the first outward signs that a parent or caregiver will notice that something is different.
Children who experience this period of regression will lose previously learned speech or withdraw into themselves in ways that they had previously been outgoing. Many children in this phase will often begin to play with toys in an inappropriate manner such as lining up objects instead of using them for their intended purposes (such as toy cars).
Many children will become more interested in technology than their caregivers when formerly the child had preferred human interaction and attention. The cause of this regression remains in debate, and one I will leave for another set of professionals to explore as it is not my intention in this article to explore why this happens but rather the nature of the fact.
I want to take regression in autism yet one step further. What if I were to say that regression can happen at any point with an individual with autism? As a parent of a child on the more severe end of the spectrum, I was under the belief system that once a skill had been acquired and mastered, it was there to stay. I knew that unlike typical children, the plane of growth was not a constant.
While most typical peers in their development progress on a continuous upward plane, a child with autism will not have a constant progression forward. I was aware that there would be periods of upward momentum followed by periods of plateau followed by another period of incline but what threw me off was when my son actually began to regress after a long period of therapeutic intervention.
To illustrate what I mean by regression in older children with autism, I will illustrate my own story. We had worked for years to potty train my child who, at the age of eight, finally mastered this skill. By mastered, I mean he didn’t require any assistance with toileting and even stayed dry at night. This became a skill that I no longer thought of as something even on my radar. I would often beam with pride in telling others “he is my most potty trained kid!” until one day at the age of 10, he had one accident, then another, then another until he was back in Pull-Ups full time.
We tried everything. We tried taking him to the toilet on a fixed schedule of 30 minutes; we tried using schedules and potty contracts (If you stay dry until 1 p.m. you get ___) and the like. We tried no pants, tight pants, shorts, you name it we tried it. We examined the environment for any changes and discussed any possible traumas (which there were none) and even went to the emergency room where all possible medical contributors were ruled out. And after all of this intervention over four months, the need for Pull-Ups continued.
In dismay and mere exhaustion, I quickly began to realize that, at this point, no amount or form of intervention would curb this behavior. In dismay and feeling defeated I stocked up on Pull-Ups as they went on sale and continued rewarding the desired behavior as it occurred and prompting intermittently as I saw fit.
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Now, nine months after the regression he was out of Pull-Ups, and his speech increased exponentially, his attending skills are notably stronger, and his self-help abilities have also improved. So while one skill went into regression for a short time, the rest of his skills remained on the incline. I have come to believe that one day, this previously mastered skill with prompting and encouragement will surface after this period of incline. Though we still have occasional accidents, we are essentially Pull-Ups-free (we do have some bad days I’ll admit).
I am writing this article not to scare those of you at the start of our journey with autism but rather to let you know that regression of previously acquired skills is not solely for those in toddlerhood. Regression can occur at any stage in your child’s habilitation, and regression of a previously mastered skill does not signify an implicit negative impact on your child’s development.
Sometimes a skill can decline as another skill inclines, and while this may be frustrating or even scary in some cases, sometimes it is best to wait out the target behavior while implementing light interventions until the incline in your child’s other skills reach a plateau. Though I admit that I am unsure of the function of the regressive features at this time, I am sure that working towards a goal using tools that are not helping the target behavior to decline does nothing more than cause frustration for the child and the caregivers involved in the implementation of such programs.
For instance, potty training a typical child at the age of one year could take a year to complete the program because that child was not ready to acquiesce the skill but if you were to wait until both the age and signs of readiness were evident it would take a significantly less amount of time to teach the skill. Sometimes, the “waiting it out” method is the right method not only for the behavior in question but also for the well being of the individual and all those involved in their care. Always remember that a regression now does not mean a regression later.
This article was featured in Issue 92 – Developing Social Skills for Life