Abstract | Regresija kod poremećaja iz spektra autizma (PSA) je složen fenomen čija je podloga još uvijek nepoznata i za čije uzroke ne postoje čvrsti i neoborivi znanstveni dokazi. Roditelji djece s regresivnim oblikom autizma najčešće opisuju djetetov rani razvoj kao uredan razvoj koji prati razvojne miljokaze, bez značajnih atipičnosti i razloga za zabrinutost. Takav uredan razvoj, prema riječima roditelja, uglavnom naglo biva prekinut, dijete počinje nazadovati i pokazivati jasne znakova autizma. Međutim, istraživanja govore drugačije – da je kod malog broja djece razvoj prije pojave regresije zaista bio uredan, a da kod većine djece pojavi regresije prethode suptilna odstupanja koja roditelji često ne prepoznaju, ali ih mogu uočiti stručnjaci razvojnim praćenjem. Budući da je regresija još uvijek zapanjujuća nepoznanica, jedan od ciljeva ovog rada bio je opisati njezina obilježja u komunikacijskoj i jezičnoj domeni razvoja. Osim ovih dviju navedenih domena, navedena su i obilježja koja karakteriziraju socijalne vještine, kao i čimbenici koji se često povezuju s regresivnim PSA-om. Pružen je i uvid u razlike u razvojnim ishodima djece s PSA-om bez regresije i sa regresijom, kao i pogled na novija promišljanja o fenomenu regresije. U istraživačkom dijelu rada proveden je online upitnik među roditeljima djece s PSA-om kojim se željelo utvrditi koje su vještine najviše zahvaćene regresijom, javlja li se regresija češće izolirano u pojedinim vještinama ili u kombinaciji s drugim vještinama, s kojim događajima roditelji povezuju pojavu regresije i postoje li neka medicinska stanja koja se često javljaju kod ovog oblika PSA-a. Rezultati istraživanja pokazali su da se regresija, ovisno o definiciji, javlja najčešće u komunikacijskim vještinama (kod 71,8% djece) ili prema drugoj definiciji u jezičnim vještinama (66,2%). U nešto manjoj mjeri zahvaća socijalne vještine (43,7%), dok se kod vještina svakodnevnog života javlja u najmanjem broju slučajeva (15,5%). Za vještine socijalne igre manji broj roditelja je izvijestio da je došlo do regresije (35,2%), kao i za
socijalne interakcije (28,7%). Na odgovor s čime povezuju gubitak vještina, 36% roditelja se izjasnilo da ne povezuju ni sa čim, dok je 21% roditelja navelo isključivo cijepljenje kao događaj s kojim povezuju regresiju, a kada u to ubrojimo i kombinaciju cijepljenja i drugih čimbenika, cijepljenje je ukupno navedeno u 43% slučajeva. Nisu pronađena medicinska stanja koja su u značajnom postotku prisutna kod djece s regresijom. |
Abstract (english) | Regression in autism spectrum disorder is a complex phenomenon whose basis is still unknown and for whose causes there is no solid and irrefutable scientific evidence. Parents of children with a regressive form of autism most often describe the child's early development as an typical development that follows developmental milestones, without significant abnormalities and reasons for concern. Such typical development, according to the parents, is usually abruptly interrupted, the child begins to regress and show clear signs of autism. However, researches say otherwise - that in a small number of children the development before the onset of regression was unquestionably typical and that in most children the onset of regression is preceded by subtle deviations that parents often do not recognize but can be spotted by experts through developmental monitoring. Since regression is still an astonishing obscurity, one of the goals of this paper was to describe its characteristics in the communication and language domains of development. In addition to these two mentioned domains, features that characterize social skills are also listed, as well as factors that are often associated with regressive ASD. An insight into the differences in the developmental outcomes of children with ASD with and without regression is also provided, as well as a look at recent considerations on the phenomenon of regression. In the research part of the paper, an online questionnaire was conducted among parents of children with ASD, which aimed to determine which skills are most affected by regression, whether regression occurs more often in isolation in certain skills or in combination with other skills, with which events parents associate the occurrence of regression and are there any medical conditions that often occur with this form of ASD. The results of the research showed that regression, depending on the definition, occurs most often in communication skills (in 71.8% of children) or,
according to another definition, in language skills (66.2%). It affects social skills to a slightly lesser extent (43.7%), while it occurs in the smallest number of cases (15.5%) in everyday life skills. For social play skills, a smaller number of parents reported that there was a regression (35.2%), as well as for social interactions (28.7%). In response to what they associate the loss of skills with, 36% of parents declared that they do not associate it with anything, while 21% of parents cited only vaccination as the event with which they associate the regression, and when we include the combination of vaccination and other factors, vaccination is the total stated in 43% of cases. No medical conditions were found that are present in a significant percentage of children with regression. |