It’s the dream of any parent whose child is diagnosed with autism: The symptoms will fade away over time.
What keeps the dream alive is that in rare cases it comes true. Several studies over the years have documented cases in which children have improved so much that they no longer meet the criteria for diagnosis or require extra support in school.
Those children have long presented a puzzle to researchers. What distinguishes them from people for whom autism is a lifelong condition? And what distinguishes them from people with typical early childhood development?
Deborah Fein, a psychologist at the University of Connecticut, is beginning to answer those questions. In a study published this week in the Journal of Child Psychology and Psychiatry, her team recruited 34 people who had been diagnosed with autism early in life but now appear to be functioning normally.
The study was limited to people who had been diagnosed by autism experts — an attempt to avoid cases in which the label had been used improperly. In addition, records documented the one-time presence of the disorder’s hallmark symptoms: problems with socialization and communication, and repetitive behaviors or obsessive interests. The research subjects ranged in age from 8 to 21.
For comparison, the authors assembled two other groups: 34 people whose development was normal and 44 who have autism without an intellectual disability.
The researchers wondered whether those who lost the diagnosis still had subtle vestiges of the disorder. For the most part, the answer was no. In tests looking at socialization and communication, they performed as well as the typical children. Three, however, scored below average in facial recognition — a common difficulty in autism.
The study also reviewed early developmental history and compared the children who seemed to grow out of their autism with those who did not. The two groups had equally severe problems with communication and repetitive behaviors. But the children who shed the diagnosis started out with milder social difficulties.
The researchers also conducted brain scans and gathered data looking at executive function, academic performance, psychiatric functioning, memory, language and treatment history. Those results will be reported in subsequent studies.
The data cannot address how many children with an autism diagnosis have the capacity to eventually lose it.
The autism caseload has skyrocketed over the last two decades, largely because of an expanded definition of the disorder and more aggressive attempts to identify it. The diagnosis is used to describe a huge range of children — from the mentally retarded and self-injurious to the preternaturally bright but socially awkward.
Until there is a blood test or some other definitive bio-marker for the disorder, the question will always remain whether children who beat autism ever really had it — or whether autism is even a single disorder.
You can read the study online here.
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