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Language regression in childhood.

Shlomo Shinnar1, Isabelle Rapin2, Susan Arnold3

  • 1Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA; The Comprehensive Epilepsy Management Center at Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; The Children's Evaluation and Rehabilitation Center at Rose F. Kennedy Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Pediatric Neurology
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Summary
This summary is machine-generated.

Language regression in children, often linked to autism, impacts cognition and behavior. Early identification and intervention are crucial for improving long-term outcomes in affected children.

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Area of Science:

  • Developmental Neuroscience
  • Pediatric Neurology
  • Clinical Psychology

Background:

  • Language regression is a significant concern in pediatric neurology, appearing in conditions like autistic regression and Landau-Kleffner Syndrome.
  • Understanding the characteristics and associations of language regression is vital for early diagnosis and intervention.

Purpose of the Study:

  • To prospectively identify and characterize children experiencing language regression.
  • To investigate the association between language regression, autistic features, seizures, and electroencephalogram (EEG) abnormalities.
  • To determine the long-term language and cognitive outcomes in children with language regression.

Main Methods:

  • Prospective identification of 177 children with language regression across four major medical centers.
  • Detailed recording of clinical characteristics, including age at regression, referral time, autistic features, and seizure history.
  • Analysis of electroencephalogram (EEG) findings and language function at follow-up.

Main Results:

  • The mean age of language regression was 22.8 months, with a mean referral time of 38 months.
  • 88% of children exhibited autistic features; males and those regressing before age 3 were more likely to develop autistic behaviors.
  • Seizures were more common in children regressing after age 3 and were inversely associated with autistic regression. EEG abnormalities were present in 37% of patients, more common in those with seizures.
  • Language function remained impaired in 88% at follow-up, though 57% showed some improvement.

Conclusions:

  • Language regression, even with limited initial language loss, often indicates broader cognitive and behavioral regression with significant implications for future function.
  • Early identification and specialist referral are essential for timely diagnosis and intervention in children with language regression.
  • The study highlights the complex interplay between language regression, autism, and epilepsy in children, underscoring the need for comprehensive assessment.