Study Shows Very Few Children Can Outgrow An Early Autism Diagnosis, Still Need Support
Some children who are diagnosed with autism at a young age appear to “outgrow” or “move past” an autism diagnosis as they grow older. However, autism is considered by the medical community to be a life-long disorder; it is not something that can be “cured.”
Tailored therapies are instrumental in helping people with ASD cope with sensory, social, and developmental difficulties. Generally, the earlier these tools are used, the better their odds are of managing any associated issues. On top of that, some people on the spectrum are able to “mask” autistic behaviors or tendencies.
So when an individual with autism seems to no longer need services, do they truly lose the disorder?
Researchers found that, though a small number of toddlers who receive an autism diagnosis appear to shed their diagnosis later in life, most of them do continue to struggle in other areas, like language and behavior.
A research team strove to answer the question in their study: When an Early Diagnosis of Autism Spectrum Disorder Resolves, What Remains? The study was published in the Journal of Child Neurology and led by a team at Albert Einstein College of Medicine and Montefiore Health System.
The team looked at the records of 569 children, all of whom were diagnosed before they were three years old at the researchers’ own autism center between 2003 and 2013. Almost all of the children underwent early intervention, such as speech therapy, occupational therapy, applied behavioral analysis (ABA), and other targeted therapies.
After four years of these therapies, they found that 38 of the 569 kids (a little under 7%) no longer met the diagnostic criteria for autism. All of these kids had been high-functioning/low needs from the start.
However, even though they no longer met the criteria for autism after four years, most of the children still had some type of developmental, language, or behavioral disorder.
Over two-thirds (68%) of the 38 children still had a language or learning disability; about half of them had externalizing behavior disorders, like ADHD and oppositional defiant disorder (ODD); a quarter of the children had internalizing disorders, like anxiety or obsessive compulsive disorder (OCD); and two of the children had intensive mental health issues, like psychosis.
Only three of the children had no other disorder after they shed their autism diagnosis.
According to the lead author of the study, Lisa Shulman, M.D., a professor of pediatrics at Albert Einstein College of Medicine, why these children improved isn’t totally clear.
“Our findings beg the question, what is going on with these children who no longer have an ASD diagnosis?” said Dr. Shulman. “Was autism initially over-diagnosed? Are some children better able to respond to intervention? Does the specific intervention the child receives contribute to outcome?
“Our sense is that some children with ASD respond to intervention while others have unique developmental trajectories that lead to improvement. Those children who evolve in a positive direction generally have the mildest symptoms to begin with.”
Whether these children lost their diagnosis due to early intervention or were misdiagnosed — or something else entirely — an autism diagnosis got them access to services that proved beneficial in the end.
The study was incredibly encouraging, but almost all of the children in the study did still struggle in some areas of their daily lives, Dr. Shulman emphasized.
“The message from our study is that some of our kids do amazingly well, but most of them have persistent difficulties requiring ongoing monitoring and therapeutic support,” said Dr. Shulman.