Autism Regression at 18-24 Months: A Guide for NJ Parents

What Is Autism Regression?

Autism regression-sometimes called autistic regression or developmental regression-is when a child who appeared to be developing typically starts to lose previously mastered skills. This often involves language, such as words the child once used regularly, and social abilities like responding to their name or making eye contact. Regression can also include loss of motor or self-help skills. For many families, the changes feel sudden and alarming.

Research suggests that regression occurs in approximately 25-30% of children later diagnosed with autism spectrum disorder (ASD). The most common window is between 18 and 24 months of age, though it can happen earlier or later. It is important to note that regression does not always mean autism-other neurological conditions can cause skill loss-but it is a strong indicator that a comprehensive evaluation is needed.

Signs of Regression at 18-24 Months

Recognizing regression early is crucial because earlier intervention leads to better outcomes. In New Jersey, the Early Intervention System (NJEIS) offers free evaluations for children under three years old. Here are specific behaviors to watch for between 18 and 24 months:

Language and Communication

• Stopping the use of words they previously said (e.g., "mama," "dada," "ball").
• No longer imitating sounds or gestures like waving and pointing.
• Not combining words (by 24 months, most children use two-word phrases).
• Loss of babbling or vocalizations.

Social Skills

• Reduced or absent eye contact.
• Less interest in playing with parents or peers-may seem to "live in their own world."
• No longer responding to their name.
• Loss of social smile or shared enjoyment (e.g., not looking at you when showing a toy).

Play and Behavior

• Decreased or absent pretend play (e.g., feeding a doll).
• New repetitive behaviors such as hand-flapping, rocking, or spinning objects.
• Unusual sensory responses-covering ears from sounds that didn't bother them before, or staring at lights.
• Increased insistence on routines and distress over small changes.

If you notice any of these changes, trust your instincts. You do not need a doctor's referral to contact NJEIS-call 1-800-322-8174 and say "I think my child may be regressing and I want an evaluation."

Why Does Regression Happen?

The exact cause of autistic regression is not yet fully understood, and researchers continue to study it. Several theories exist, but none are proven definitively:

• Neural pruning differences: The brain naturally prunes unused connections during development; in autism, this process may become exaggerated, affecting language and social circuitry.
• Heightened stress or inflammation: Some studies suggest that immune system activation or chronic stress during toddlerhood could trigger regression in genetically vulnerable children.
• Atypical brain development: The brain may develop in a way that initially allows skill acquisition but then cannot sustain those skills as demands increase.

What is clear is that regression is not caused by parenting, vaccines, or diet. It is a neurobiological event. The most important thing is not to dwell on why, but to act quickly: early behavioral intervention can help the brain rebuild those connections.

Why Early Intervention in New Jersey Matters

New Jersey has one of the strongest early intervention systems in the country. Under the federal Individuals with Disabilities Education Act (IDEA), Part C, NJEIS provides evaluations and services for children from birth to three years. If your child is found eligible (based on a 33% delay or a diagnosed condition like autism), they can receive therapies at no cost to your family, regardless of income.

Key NJ resources:

• NJEIS (1-800-322-8174): Free evaluation and early intervention services.
• PerformCare (1-877-652-7624): Coordinates behavioral health services for children with autism who are on NJ FamilyCare.
• NJ Autism Insurance Mandate: Requires most commercial health plans to cover medically necessary ABA therapy, with no age caps (though benefits vary by plan).
• NJ FamilyCare (Medicaid): Covers ABA therapy through approved providers.

If you suspect regression, you can contact NJEIS directly while simultaneously speaking with your pediatrician. Early intervention can include speech therapy, occupational therapy, and developmental instruction. For autism-specific support, applied behavior analysis (ABA) therapy is considered the gold standard.

How In-Home ABA Therapy Can Help After Regression

ABA therapy focuses on teaching skills and reducing challenging behaviors by understanding the function of a child's actions. When a child has regressed, ABA can help re-teach lost skills-like using words or making eye contact-in a structured, positive way. In-home ABA is especially valuable for young children because it happens in their natural environment: their own home, with familiar people and routines.

Benefits of in-home ABA for regression:

• Individualized: A board-certified behavior analyst (BCBA) designs a plan based on your child's specific skill loss, strengths, and family goals.
• One-on-one attention: A dedicated therapist works with your child, ensuring consistent, focused teaching.
• Parent coaching: You learn strategies to support your child's communication and social engagement between sessions.
• Naturalistic teaching: Skills are taught during everyday activities-mealtime, bath time, play-which helps children generalize them more quickly.

Liftoff ABA provides in-home ABA therapy across New Jersey with no waitlists. As soon as your child's evaluation is complete (either through NJEIS or a private diagnostic assessment), Liftoff's BCBAs can begin designing and supervising a personalized program. They work with most major insurance plans, including NJ FamilyCare, and offer free benefit verification. Many families start within weeks, not months.

Steps for New Jersey Parents If You See Regression

1. Document what you see: Write down which skills your child has lost and when you first noticed. Video recordings can be very helpful for professionals.
2. Contact NJEIS: Call 1-800-322-8174 to request a free evaluation. You can do this right away without a doctor's referral.
3. Talk to your pediatrician: Share your concerns and your documentation. Ask for a referral to a developmental pediatrician or child neurologist if you want a formal autism diagnosis.
4. Start early intervention services: Even before a formal diagnosis, NJEIS can provide speech, occupational, or developmental therapy. These help maintain and build skills.
5. Research ABA therapy providers: Look for agencies that offer in-home services and have availability. Liftoff ABA is one option that promises no waitlists, which can be critical during this window of neuroplasticity.
6. Verify your insurance benefits: Contact Liftoff ABA at (973) 566-3180 for a free benefits check. They accept most insurance and NJ Medicaid, and they handle the paperwork.

Supporting Your Child at Home While You Wait for Services

The time between noticing regression and starting formal therapy can feel like an eternity. Here are evidence-informed strategies you can use right away:

Follow Their Lead

Joining in with whatever your child is doing-even if it's spinning a wheel or lining up cars-can build connection. Sit at their level, imitate their actions, and narrate simply. For example, if they are spinning a car wheel, you spin one too and say "round and round." This shared attention can sometimes spark social engagement.

Use Visual Supports

Many children with autism understand visual information better than spoken language. Use pictures, gestures, or simple signs to communicate. For instance, show a cup when offering a drink, or use a "first/then" board (first story, then bubbles).

Create Predictable Routines

Regressed children often find comfort in predictability. Use a visual schedule (photos of daily activities) so they know what comes next. This reduces anxiety and may help them feel safe enough to attempt communication.

Reduce Demands

If your child is overwhelmed, lower your expectations temporarily. Focus on connection over compliance. Praise any attempt to communicate-a glance, a vocalization, a point. Every small step is progress.

Reach Out for Support

You don't have to do this alone. Join parent support groups (many are on Facebook or via local county special services school districts). Connect with Liftoff ABA for a no-commitment consultation-they can answer your questions about ABA, insurance, and next steps.

The period of regression is frightening, but it is not a dead end. With early identification and intensive, in-home therapy, many children go on to make significant gains. New Jersey families have excellent resources at their fingertips, and providers like Liftoff ABA are ready to partner with you on this journey.

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