Autistic Young People: Skills Regression, Burnout or a shift in Monotropic Attentional Resources?

Be Curious

Having worked in Early Years SEND settings for over twenty years, one recurring concern I sometimes heard from parents and carers was that their child seemed to be “going backwards” or “regressing.” It may have looked like the child was losing previously learnt skills such as speech and language, fine or gross motor abilities, or executive functioning skills. These shifts often coincided with heightened sensory dysregulation and more meltdowns or shutdowns.

Fluctuations in development are a natural part of growth for all children. For example, a toddler learning to walk may temporarily show slower progress in language development. However, for neurodivergent children, especially those with learning disabilities or medical needs, these shifts can be more visible and more likely to prompt concern from parents and teachers. This can lead to interventions aimed at helping the child “catch up” and work towards neurotypical milestones. It is important to take these concerns seriously; any sudden change or what looks like regression could signify a need for medical, health or social care support, or it may indicate PANS/PANDAS. However, it is also important to be curious and question if it is actually a skills regression or perhaps if it is a redistribution of energy and monotropic attentional resources or may be a sign of burnout.

What does regression look like?

As suggested by Musings of an Aspie (2013), regression can refer to a specific set of skills or abilities:

• progressively losing the ability to speak
• deteriorating executive function
• reduced memory capacity
• loss of self-care capabilities
• loss of social skills
• reduced ability to tolerate sensory or social overload

It can also refer to a general loss of the ability to cope with life or to accomplish all of the necessary daily tasks of living. Sometimes, what looks like a loss of skills may only be a short-lived experience, a period of a few weeks or months, or it may last much longer. As Musings of an Aspie suggests, Autistic people may have a more fluid way of adapting to their environment and being Autistic may mean ‘a lifetime of fluid adaptation’. 

Redirection of monotropic attentional resources?

Monotropism is a neuro-affirming, strength-based theory of Autism. Autistic / ADHD people are more likely to be monotropic. There is no research yet about monotropism and young people, but it makes sense that monotropic adults were once monotropic children! If you’re monotropic, you naturally focus more of your attentional resources and energy on fewer things at a time but in much greater depth (Garau, 2023; Murray et al., 2005).

For Autistic and otherwise neurodivergent children, development often doesn’t follow a neat, linear path. Autistic children may not hit all the developmental milestones at the expected times, some may be early, some late, and you may still be waiting for your child to reach some expected milestones even when they are much older, not because they are delayed in their development but maybe because their development is different and doesn’t follow a neurotypical pattern. Autistic children’s development is more fluid and full of peaks and troughs; it ebbs and flows to reflect how children’s attention and energy resources are distributed. This is especially true for Autistic and ADHD individuals, who are more likely to be monotropic.

Spiky Profiles

The theory of monotropism may help explain why Autistic development can appear “spiky.” This spikiness isn’t just about academic strengths and challenges, like being good at number work but struggling with reading and writing. It also shows up in children having spiky sensory processing profiles and impacts social interaction and communication. All of these areas may fluctuate depending on an Autistic person’s energy, capacity, interests, how they are using their attentional resources and how well the environment is meeting their needs. It is also worth bearing in mind how things like the interoception sensory system may play a part too!

When a young Autistic child is focused intensely on developing one area, for example, learning to walk and exploring how their body moves, then other areas like fine motor skills and speech and language and social communication skills might temporarily plateau or sometimes seem to regress. This may be more apparent if a child is Autistic due to the way their attentional resources are distributed. If a child is polytropic (i.e. not monotropic Autistic/ ADHD), then they may still have some ebbs and flows in their development, but because their attentional resources are distributed across more areas of interest at any time, it may not be quite as noticeable or raise such concern.

I am suggesting that Autistic individuals may not be losing their skills or be regressing, but rather, their monotropic attentional resources are perhaps being redirected and channelled into different interests and different areas of development. It is not that they have lost skills but rather that they have less capacity and ways to access prior skills. Their monotropic attentional pulls may be directing them to learn other skills and be engaged in other interests and sensory experiences that may not align with neurotypical expectations of a child’s development.

If it looks like a child has lost skills or is regressing, it may be that their learnt skills are still there, but their attentional resources may be being redistributed as they pick up other skills or focus on other interests. Over time, many children loop back and revisit other areas of learning. For lots of children, things balance out a bit as they get older, but if a child is neurodivergent, they will often always have a much spikier profile, and that is ok – it is something to lean into and develop their strengths, interests and passions.

What may look like skills regression could be a natural shift in focus and attentional resources due to being monotropic, or it may be that environmental pressures and unmet needs are contributing towards burnout. Sometimes, what looks like a loss of skills could be the result of a child trying to live in survival mode, conserving their energy or trying to regulate in an environment that isn’t meeting their needs.

Burnout?

The redistribution of monotropic attention resources and energy and the ways monotropic people experience and develop can be misunderstood, especially in systems built around neuronormative developmental milestones. In many settings, a perceived regression of skills can trigger interventions aimed at helping children “catch up.” However, while often well-intentioned, these interventions and well-meaning support plans may inadvertently contribute to what we now understand as Autistic burnout (Raymaker et al., 2020). Increasing demands lead to further stress and can contribute to more sensory overwhelm, so people have even less capacity and energy to manage. It is easy to see how this can lead to a bit of a spiral.

Autistic people’s spiky profiles and the ebbing and flowing of skills and interests are likely to always fluctuate as energy shifts and interests change over time. Big life events and transitional times, such as starting school and puberty, may all impact a young person’s energy and capacity as they have more demands to juggle. Being curious as a parent/carer and professional is important. What looks like skills regression may actually reflect a spiky profile and the fluid, non-linear way some Autistic people naturally learn and manage their daily lives.

Alternatively, what looks like skills regression may indicate that an Autistic person is struggling and doesn’t have the energy to manage; the demands of life may outweigh their capacity (Raymaker, 2019). Through the lens of monotropism, I think having shifting, fluctuating skills and abilities makes sense, especially for young people who are growing so quickly and perhaps more so during transitional times of a person’s life when they are dealing with more stress and demands. Attentional resources and energy are limited, and skills and interests can evolve, ebb and flow, or re-emerge depending on where an Autistic person’s focus lies.

Monotropic Capacity and Energy

Viewing energy and capacity through the lens of monotropism can help us understand that rather than Autistic people regressing or losing skills, it may be that some people have a more dynamic, responsive, monotropic learning style. What looks like skills regression may be a redistribution of energy resources; this may be more observable in Autistic young children as they are developing or for those who are experiencing burnout. Understanding these shifts through a neuro-affirming, monotropic lens allows us to support Autistic young people in ways that respect their natural rhythms and capacities.

Note:
This blog was inspired by a post by Kelly Mahler on LinkedIn (15th April 2025), citing Kieran Rose’s work and his 2018 blog about Autistic Burnout.

Kelly Mahler wrote:
“This recently blew my mind: Is the ‘regression’ that is common for many toddlers, where they have a sudden decline in developmental milestones (e.g., talking, moving, etc), actually Autistic Burnout?

In this blog post written by my friend Kieran Rose: “There is a school of thought amongst the Autistic Community… that when Autism first becomes ‘apparent’ to parents… the child is undergoing Autistic Burnout—their apparent ‘Autistic Regression’ is because they have had some kind of event… that has overwhelmed them to the point that their mask (which starts establishing itself very early on) has completely dropped off.”

Kieran challenges the myth of “autistic regression” and reframes it as early burnout—a protective shutdown after being overwhelmed by environmental demands.

My key takeaway as an OT: If we called it ‘early burnout’ instead of ‘regression,’ how differently might we respond? I bet it wouldn’t be thru 40 hours a week of ‘skill building’!!! Just sayin’.”

I responded:

“I agree, I don’t think we’re seeing skills regression in burnout, but rather a shift in capacity and energy. It’s more about a redistribution of energy when someone is in survival mode. Things like speech or executive functioning and physical skills may take a back seat, which can look like regression from the outside. What sometimes appears as regression might actually be a reallocation of energy and for some children, especially those who are monotropic, this might explain things too?
There’s so much going on developmentally in the early years, and whether a child is Autistic or not, we often see temporary fluctuations in abilities when they’re focusing on new skills. For example, when a child is learning to walk sometimes their speech or language development might plateau or even seem to regress a little. This is really common in all children, but it tends to be more noticeable in neurodivergent children and those with learning disabilities.
Everyone has limited energy and attentional resources. What looks like regression might actually be a sign of burnout, or it could be that they’re channelling their energy resources into developing other skills or following a specific interest (or both).“

(I ran out of characters to reply on LinkedIn, so wrote this blog!)