months to 3 years. The second pattern, childhood disintegrative disorder (a diagnosis now included under ASD), is characterized by regression after normal development in the first 3 to 4, or even up to 9 years of life. After the regression, the child follows the standard pattern of autistic neurological development. The term regressive autism refers to the appearance that neurological development has reversed; it is actually only the affected developmental skills, rather than the neurology as a whole, that regresses. Usually, the apparent onset of regressive autism can be surprising and distressing to parents, who often initially suspect severe hearing loss. Attribution of regression to environmental stress factors may result in a delay in diagnosis. There is no standard definition for regression. Some children show a mixture of features, with some early delays and some later losses; and there is evidence of a continuous spectrum of behaviors, rather than, or in addition to, a black-and-white distinction, between autism with and without regression. There are several intermediate types of development, which do not neatly fit into either the traditional early onset or the regressive categories, including mixtures of early deficits, failures to progress, subtle diminishment, and obvious losses. Regression may occur in a variety of domains, including communication, social, cognitive, and self-help skills; however, the most common regression is loss of language. Some children lose social development instead of language; some lose both. Skill loss may be quite rapid, or may be slow and preceded by a lengthy period of no skill progression; the loss may be accompanied by reduced social play or increased irritability. The temporarily acquired skills typically amount to a few words of spoken language, and may include some rudimentary social perception. The prevalence of regression varies depending on the definition used. If regression is defined strictly to require loss of language, it is less common; if defined more broadly, to include cases where language is preserved but social interaction is diminished, it is more common. Although regressive autism is often thought to be a less common (compared with gradual course of autism onset described above), this remains an area of ongoing debate; some evidence suggests that a pattern of regressive autism may be more common than previously thought. There are some who believe that regressive autism is simply early-onset autism which was recognized at a later date. Researchers have conducted studies to determine whether regressive autism is