Corticosteroid therapy in regressive autism

Could steroid treatment be indicated for some children with regressive autism? That was the question examined in a paper by Frank Duffy and colleagues* based at the Boston Children’s Hospital in the United States. Looking retrospectively at the records of 20 children with a documented history of regressive autism, characterised by loss of age-appropriate skills, who undertook a course of oral prednisolone, researchers examined various outcomes compared with a selected comparison group of untreated children. Examinations were based on results recorded in a database containing records for several thousand patients and research participants.

Looking specifically at any changes to “the frequency modulated auditory evoked response (FMAER)” according to an accompanying editorial on the Duffy study**, researchers reported positive differences alongside signs of clinical improvement in respect of “receptive and expressive language skills and behavioral manifestations of autism” in those receiving steroid therapy. Researchers were also able to discount natural remission of autistic symptoms to some degree as being due to the regressive nature of autism presentation based on analyses of control participant data.

The authors accept that their study has various important limitations including the facts that the study was retrospective and was not the same quality as that derived from more controlled research which includes blinding and the use of a placebo arm. Their focus on regressive autism also means that results may not be transferable to the majority of people on the autism spectrum who report no regressive symptom onset. The added concern of side-effects from medicines such as prednisolone including weight gain and the requirement for close monitoring of any medium or longer-term use of the drug means that this intervention option may not be suitable for some people.

They add however that further investigations are indicated based on both the effects of intervention and the changes noted to FMAER; indeed whether this technique could be similarly investigated when it comes to other intervention options.


* Duffy FH. et al. Corticosteroid therapy in regressive autism: a retrospective study of effects on the Frequency Modulated Auditory Evoked Response (FMAER), language, and behavior. BMC Neurol. 2014 May 15;14(1):70.

** Golla S. & Sweeney JA. Corticosteroid therapy in regressive autism: Preliminary findings from a retrospective study. BMC Medicine 2014, 12:79

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