Children With Autism Spectrum Disorder and Neurodevelopmental Regression Present a Severe Pattern After a Follow-Up at 24 Months

This study examined the presence of neurodevelopmental regression and its effects on the clinical manifestations and the severity of autism spectrum disorder (ASD) in a group of children with autism compared with those without neurodevelopmental regression at the time of initial classification and subsequently.Methods and Subjects: ASD patients were classified into two subgroups, neurodevelopmental regressive (AMR) and non-regressive (ANMR), using a questionnaire based on the Autism Diagnostic Interview-Revised test. The severity of ASD and neurodevelopment were assessed with the Childhood Autism Rating Scale Test-2, Strengths and Difficulties Questionnaire, and Pervasive Developmental Disorders Behavior Inventory Parent Ratings (PDDBI) and with the Battelle Developmental Inventory tests at the beginning of the study and after 24 months of follow-up. Fifty-two patients aged 2–6 years with ASD were included. Nineteen were classified with AMR, and 33 were classified with ANMR.Results: The AMR subgroup presented greater severity of autistic symptoms and higher autism scores. Additionally, they showed lower overall neurodevelopment. The AMR subgroup at 24 months had poorer scores on the Battelle Developmental Inventory test in the following areas: Total personal/social (p < 0.03), Total Motor (p < 0.04), Expressive (p < 0.01), and Battelle Total (p < 0.04). On the PDDBI test, the AMR subgroup had scores indicating significantly more severe ASD symptoms in the variables: ritual score (p < 0.038), social approach behaviors (p < 0.048), expressive language (p < 0.002), and autism score (p < 0.003).Conclusions: ASD patients exhibited a set of different neurological phenotypes. The AMR and ANMR subgroups presented different clinical manifestations and prognoses in terms of the severity of autistic symptoms and neurodevelopment.

Collaboration and critique

What is the place for critical ethnography in global health and other related forms of international intervention? This essay explores this question through my experience collaborating with a nongovernmental organization (NGO) working to improve children’s well-being in El Salvador and with a team of quantitatively oriented researchers evaluating the NGO’s project. I adopt as an analytic lens one of the metrics the researchers used – the Battelle Developmental Inventory – in order to explore the possibilities for dialogue among quantitative and qualitative methods (and researchers). At issue is the place that critique can have in such dialogues, particularly when the aims of NGOs, public health researchers, and ethnographers can sometimes be at odds. Ultimately, I make the case that viewing critique as a praxis, keeping an eye on the commensurability of aims, and being prepared for occasional productive friction are some practical steps for bringing critical ethnographic perspectives into contact with interventions.