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. 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. 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. 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. 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.

中文翻译：

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自闭症患者的卡口式语言发展与回归：一项回顾性研究

语言延迟是自闭症评估的主要转诊标准之一。一旦确定了自闭症谱系诊断，语言预后是父母主要关心的问题之一。10-50% 的父母观察到早期语言回归 (ELR)，但其与晚期语言水平和社会交际能力的相关性尚不确定。本研究旨在确定 ELR 对语言发展进程和社会交际结果的预测价值，以指导临床医生在诊断时解决父母的担忧。我们使用了来自 Simons Simplex Collection 的 2,047 名自闭症谱系参与者的社会交流、语言和认知数据，年龄在 4-18 岁（平均 = 9 岁；SD = 3.6）。Cox 比例风险和逻辑回归模型用于评估 ELR 对语言里程碑的影响以及使用复杂和灵活语言的概率，这由入学时选择的 ADOS 模块定义。然后使用线性模型来评估 ELR 和非语言智商与社会交际和语言水平的关系。ELR 与较早的语言里程碑相关，但延迟达到流利、复杂和灵活的语言。然而，对于几乎所有 18 岁没有智力残疾的自闭症儿童来说，这种语言结果是可以预期的。它主要受非语言智商的影响，而不是 ELR。根据 Vineland 和 ADOS 社会交际分量表测量的灵活语言参与者的语言和社会交际水平不受 ELR 的影响。这项研究基于对最终语言水平的相对粗略的衡量，并依赖于早期语言里程碑和 ELR 的回顾性报告。它没有前瞻性地记录语言赶上的年龄、ELR 与其他退化行为领域之间的关系，也没有记录干预的效果。对于具有 ELR 和正常水平的非语言智力的自闭症个体，语言发展遵循“刺刀形状”轨迹：早期的第一个单词随后回归，一个进展有限的平台，然后语言赶上。也不是干预的效果。对于具有 ELR 和正常水平的非语言智力的自闭症个体，语言发展遵循“刺刀形状”轨迹：早期的第一个单词随后回归，一个进展有限的平台，然后语言赶上。也不是干预的效果。对于具有 ELR 和正常水平的非语言智力的自闭症个体，语言发展遵循“刺刀形状”轨迹：早期的第一个单词随后回归，一个进展有限的平台，然后语言赶上。