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Opinion

Some who outgrew autism received early, intense therapy

by  /  27 May 2014

Many of the children with autism known to have outgrown their diagnosis received intense behavioral therapy for long periods of time during childhood, reports a study published in May in the Journal of Developmental and Behavioral Pediatrics.

This doesn’t mean that early intervention can predict outcome, the researchers say. Some children who received little intervention outgrew autism, whereas others who received many hours of treatment retained their diagnosis.

The study is the first to assess the treatment history of people with so-called ‘optimal outcome.’ However, it relies on the memories of the parents, which may not be as accurate as data collected during the child’s development.

The researchers examined 25 people who outgrew their diagnosis and 34 individuals with autism considered to be ‘high-functioning’ — that is, who have intelligence quotients higher than 77. The participants all ranged in age from 8 to 21 years, and were matched by sex, nonverbal intelligence scores and family income.

Unlike the so-called ‘optimal outcome’ group, the participants with high-functioning autism tended to have taken antipsychotic or antidepressant drugs as children. This may be because they had problems with mood and behavior, the researchers say.

Clinicians confirmed that those in the optimal outcome group had a diagnosis of autism before age 5, and no longer qualified for the diagnosis.

Overall, as children, those in the optimal outcome group had better social skills, such as balanced back-and-forth interactions with others, than those in the high-functioning group. However, both groups had repetitive behaviors and trouble with communication.

Interestingly, parents of the children who outgrew their diagnosis recalled reporting concerns to a pediatrician when their child was about 17 months old. They also took the child to a specialist such as a psychiatrist or geneticist at about 26 months of age. Parents of children in the high-functioning group also reported taking these actions, but a bit later: at about 22 and 44 months of age, respectively.

Perhaps this early consultation is what led to the key difference between the two groups. More than 80 percent of the optimal outcome group received services to improve speech and motor skills before 3 years of age, and more than 90 percent of them attended preschool. They also tended to have spent many hours per week in treatment, and to have participated in applied behavior analysis, an intensive therapy that targets a child’s language and social skills.

About 40 percent of this group went to therapy between 2 and 2.5 years of age, compared with 4 percent of the autism group. Only 48 percent of the autism group received services before age 3 and 56 percent attended preschool.

Alternative interventions, such as casein- or gluten-free diets or the use of supplements, did not vary between the two groups. This suggests that they do not alter the long-term outcome for people with autism.


  • Danial Chao

    The diagnosis as being an Autistic Child is too loose from the very beginning. Those kids outgrow from the dx of Autism are not miracle, because they are not Autistic.

    • smc

      This is actually addressed in the D. Fein “optimal outcome” study — for that reason all the initial files of all participants were scrutinized. Any children ‘mistakenly’ diagnosed with autism lose the suspected label by approx. age 4-5, that is not who is included in the D. Fein study. Additionally the children included in the study are older children and adolescents who would have been diagnosed at a time when 1/200 or so received the diagnosis, not 1/85 as is now the case, so the likelihood of a broad diagnosis did not occur at the time those children were diagnosed — autism and early intervention were not house-hold words, so if you got EI you most certainly qualified and there was certainly a distinctive and notable delay in development. The ADOS and ADIR are very specific tests, many children with autistic-like symptoms and behavior do not even today get diagnosed with the criteria of these evaluations.
      The D. Fein study and subsequent articles writing on optimal outcome teens are very interesting. They may live normal lives and can fit in to society, but they continue to struggle with higher cognitive functions.

  • eunildes francisca mantovaneli

    acredito sim as dietas porque eles em geral tem problemas intestinais e sempre uma dieta é bom , e també tem os que tem alergias por Glúten e com relação a suplementos pode ser bom para o intestino , sendo assim os Autistas que fazem na maioria se dão bem no estado geral do seu organismo também pode ser produtivo e saudável a mães que fazem dizem sempre que foi ótimo !sou contra qualquer tipo de remédios sem terem certeza da eficácia !

    • Planet Autism

      This is somewhat spamming. I agree that many autistics have gut problems but this is completely unrelated to the content of this article and you seem to be a proponent of miracle cures, of which there are none.

  • Planet Autism

    I completely disagree that a person can outgrow autism. At best, they would learn to compensate and mask. http://www.forbes.com/sites/emilywillingham/2013/01/17/can-people-really-grow-out-of-autism/

    Even Sfari has an article that people with the supposedly “mild” form of autism, PDD, struggle as adults. http://sfari.org/news-and-opinion/news/2011/people-with-milder-forms-of-autism-struggle-as-adults and “Contrary to popular assumption, people diagnosed with so-called mild forms of autism don’t fare any better in life than those with severe forms of the disorder.”

    So researchers need to take the blinkers off and understand what they are looking at.

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