Autism: Even Severe Cases Can Improve

Everyone involved in the care of a child diagnosed with autism spectrum disorder (ASD) wants to know that child’s long-term prognosis. Some studies suggest that children with ASD will generally grow into adults who need supportive care. Others have found that some autistic kids will lose the ASD diagnosis at some point. The unanswered question has been whether severity of symptoms in early childhood predicts the future of ASD kids.

In a study in JAMA Psychiatry Peter Szatmari, MD reports on his study of 421 newly diagnosed preschoolers in a Canadian multisite longitudinal study. Data were collected over 4 years, until each child was age 6.

The subjects’ autistic symptom severity was tracked using the Autism Diagnostic Observation Schedule and their adaptive functioning was assessed using the Vineland Adaptive Behavior Scales, second edition. The author found that there are several trajectories ASD can take.

Children whose adaptive functioning improved over the 4 years were seen as more likely to keep improving. That was 20% of the children studied.

Tracking the children by changes in symptom severity showed that 11% experienced a decrease in that degree of severity.

“During the preschool years, there appears to be only a small amount of “yoking” of developmental trajectories in autistic symptom severity and adaptive functioning,” he wrote. For that reason, “it is imperative that a flexible suite of interventions that target both autistic symptom severity and adaptive functioning should be implemented and tailored to each child’s strengths and difficulties.”

One size does not fit all when it comes to predicting the future for ASD kids, he concluded.

“There is a remarkable diversity in levels of these developmental domains and rates of change among children with ASD.”

Children with severe ASD in their preschool years can improve and therapeutic interventions are imperative.