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Autistic regression

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Boy Hugs Bunny

"Boy Hugs Bunny" by autistic artist Miss Luna Rose

Regression is a complication that some autistic people experience when they are unable to meet life's demands. It is sometimes referred to as autistic burnout.

"In the first few years of life, some autistic toddlers reach developmental milestones, such as talking, crawling, and walking, much earlier than the average child; whereas others are considerably delayed.... Somewhere between 1 1/2 to 3 years of age; then autistic symptoms begin to emerge. These individuals are often referred to as having 'regressive' autism. Some people in the field believe that candida albicans, vaccinations, exposure to a virus, or the onset of seizures may be responsible for this regression."[1]
Regression can be frightening and confusing both to an autistic person and their loved ones.

Warning Signs

"They still have the ability to speak, or use sign language, or self care skills... Their mind and body are so tired and so exhausted, they're at a point where they no longer have the energy to expend to call up those skills and maintain and use them." Amythest Schaber[2]
Schaber lists several warning signs of autistic burnout.

  • More frequent or intense meltdowns
  • Appearing to lack motivation
  • Becoming less self-reliant
  • Seeming "more autistic"[3]

Autistic regression may be sudden or gradual, and it may be just as much of a mystery to the autistic person as to their loved ones. In some cases, it is what causes previously undiagnosed people to seek a diagnosis, because they do not understand what is going on with them.[3]

Because autistic people are often used to putting up a social facade (to pass as non-autistic), they may pretend to be okay when they are actually burning out.[4]

Causes

Cynthia Kim considers autistic regression to be characterized by "the demands of life exceeding a person's resources."

"Imagine a hot summer day in a city. Everyone turns on their fans and air conditioners to beat the afternoon heat, exceeding the ability of the power grid to supply power to all of the homes and businesses in the city. To cope, the electric company might implement a brownout–an intentional reduction of power to each building–or a series of rolling blackouts in which some locations get full power while others get none.
The autistic brain seems to work much the same way when faced with excess demands on resources.... Some coping skills or abilities are temporarily taken offline or run at reduced efficiency."[5]

Autistic Burnout from Karla's ASD Page

Autistic burnout infographic (view larger image)

Regression may be caused by...

  1. Life changes. A new school, new therapy, moving house, and other major changes can lead to autistic burnout. Transitioning from high school to college is a common example.[2]
  2. Stress or anxiety disorders.[5] Stress can make everything more difficult, including performing skills that were easier before. For example, an autistic person may no longer be able to cross the street safely after the death of her father, because her brain is too stressed to process the information.[4]
  3. Normalization. Trying to act "indistinguishable from their peers" can exact an enormous toll upon autistic people.[6] The stress of acting non-autistic (especially suppressing stims) can lead to regression.[2][7]
  4. Abuse. Autistic people can be abused, particularly in compliance- or normalization-based therapies such as ABA.[6] This may cause regression.[8][9] Parents may not realize that their child is being mistreated. Autistic people are also at higher risk of sexual, physical, and emotional abuse.
  5. Sensory Overload As a general rule, Autistic people are sensory sensitive. This can vary from person to person but an overload on any of the five senses can cause a regression. Theoretically, the sixth sense (instinct) can also be subject to an overload (see Abuse or Stress above). This can be stopped and maybe even reversed by a quick discovery of the source of the overload and rectifying it. This is key to the concept of early intervention.
  6. Another medical condition. It is important to see a doctor if you are concerned that you or your loved one is losing skills.

Getting Help

A doctor or therapist can help figure out why the autistic person is losing skills, and how to help them be comfortable and relaxed enough to have the energy to begin using those skills again. This may require a leave of absence from school or work.

Schaber considers the greatest factor in recovery to be time.[2]

To prevent future regression, autistic people should focus on living well as an autistic person, rather than trying to modify their behavior to appear neurotypical.[10] They should find ways to reduce stress in their lives, including stimming more and avoiding non-essential activities that cause stress.[2]

It is important for loved ones to remember that an autistic person who has regressed is still the same person; they are simply struggling with something more.[5] They are just as loving, and in just as need of love as they were before.

References

  1. Overview of Autism
  2. 2.0 2.1 2.2 2.3 2.4 Ask an Autistic - What is Autistic Burnout? (video)
  3. 3.0 3.1 Autism Information Library: "Help! I Seem to be Getting More Autistic!"
  4. 4.0 4.1 KATiE MiA/Aghohday: Burnout on the Autism Spectrum
  5. 5.0 5.1 5.2 Cynthia Kim: Autistic Regression and Fluid Adaptation
  6. 6.0 6.1 Love Explosions Resources: compliance, ABA, social skills, indistinguishability, whole body listening
  7. Judy Endow: Autistic Burnout
  8. An open letter to parents considering intensive behavioral therapy for their child with autism
  9. Emma's Hope Book: Tackling That Troublesome Issue of ABA and Ethics
  10. Autism, Motherhood, and Advocacy: What is autistic burnout?
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