Fact sheet on prognosis (long-term outcome) of Autism, an Autism Spectrum Disorder


Parents understandably want to know how their child with autism will cope in the future. However autism, Asperger's syndrome and other Autism Spectrum Disorders occur across a spectrum so making an accurate prognosis is difficult, particularly at a young age.


Broad range of possible outcomes with autism

Children who are diagnosed with autism face a great range of outcomes. Some are reported to have learned speech and/or writing, self-care, and social skills on their own. Others experience an apparently miraculous "recovery" and begin behaving in a way that is generally indistinguishable from the way neurotypical children behave, either for no apparent reason or, as a result of intensive early intervention.


Some children with autism become mainstreamed after years of hard work and intensive training. Some develop slowly, but never lose their diagnoses. There are a few who never move beyond a level of functioning that society perceives as 'low', yet others are fairly typical during childhood and report becoming "more autistic" in adulthood. Early diagnosis and intervention are consistently seen as the keys to improving a child's long-term future.


Most adults with moderate to severe autism usually live with their parents or living in a residential facility with carers. Some higher-functioning people live in a supported-living situation, with modest assistance, and a very few are able to live independently.


Adults with PDD/NOS and Asperger’s usually have better social skills, and are more likely to live independently and be employed as well. However, they will often have trouble maintaining employment due to still having some problems with social skills. The major reason for chronic unemployment is not a lack of job skills, but rather due to their limited social skills. Developing these abilities from a young age can make a big difference to a child's eventual ability to interact with a non-autistic world.



While some people see early intervention as crucial for autism, the prognosis is also less certain the younger the child is. An idiosyncratic development path may be confused with a more severe disorder, and the child may 'catch up' on his/her own. Research indicates that the human mind and nervous system remains plastic for longer than originally thought, and people with autism, like those with learning disabilities, have been known to cognitively develop throughout their lives.


There is broad consensus in the medical community to the effect that autistic behaviors can be improved through training and through medical or educational interventions, though there is difficulty finding consensus on treatment regimes and objectives. It is generally accepted that behavioral interventions such as Applied Behavior Analysis and the Lovaas program have had sufficient research to be established as evidence-based interventions, but there are many other interventions with insufficient research but anecdotal evidence from some parents that claims these other treatments work.


what the research says

There is no cure. Most children with autism lack social support, meaningful relationships, future employment opportunities or self-determination.[1] Children recover occasionally, sometimes after intensive treatment and sometimes not; it is not known how often this happens. [7]

Although core difficulties remain, symptoms often become less severe in later childhood.[2] Few high-quality studies address long-term prognosis. Some adults show modest improvement in communication skills, but a few decline; no study has focused on autism after midlife.[3] Acquiring language before age six, having IQ above 50, and having a marketable skill all predict better outcomes; independent living is unlikely with severe autism.[4] A 2004 British study of 68 adults who were diagnosed before 1980 as autistic children with IQ above 50 found that 12% achieved a high level of independence as adults, 10% had some friends and were generally in work but required some support, 19% had some independence but were generally living at home and needed considerable support and supervision in daily living, 46% needed specialist residential provision from facilities specializing in Autism Spectrum Disorder with a high level of support and very limited autonomy, and 12% needed high-level hospital care.[6] A 2005 Swedish study of 78 adults that did not exclude low IQ found worse prognosis; for example, only 4% achieved independence.[5] Changes in diagnostic practice and increased availability of effective early intervention make it unclear whether these findings can be generalized to recently diagnosed children.[6]



6. Howlin P, Goode S, Hutton J, Rutter M (2004). "Adult outcome for children with autism". J Child Psychol Psychiatry 45 (2): 212–29. doi:10.1111/j.1469-7610.2004.00215.x. PMID 14982237.
1. Burgess AF, Gutstein SE (2007). "Quality of life for people with autism: raising the standard for evaluating successful outcomes". Child Adolesc Ment Health 12 (2): 80–6. doi:10.1111/j.1475-3588.2006.00432.x.
2. ^Howlin P (2006). "Autism spectrum disorders". Psychiatry 5 (9): 320–4. doi:10.1053/j.mppsy.2006.06.007.
3. Seltzer MM, Shattuck P, Abbeduto L, Greenberg JS (2004). "Trajectory of development in adolescents and adults with autism". Ment Retard Dev Disabil Res Rev 10 (4): 234–47. doi:10.1002/mrdd.20038. PMID 15666341.
4. Tidmarsh L, Volkmar FR (2003). "Diagnosis and epidemiology of Autism Spectrum Disorders". Can J Psychiatry 48 (8): 517–25. PMID 14574827.
5. Billstedt E, Gillberg C, Gillberg C (2005). "Autism after adolescence: population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood". J Autism Dev Disord 35 (3): 351–60. doi:10.1007/s10803-005-3302-5. PMID 16119476.
6. Newschaffer CJ, Croen LA, Daniels J et al. (2007). "The epidemiology of Autism Spectrum Disorders". Annu Rev Public Health 28: 235–58. doi:10.1146/annurev.publhealth.28.021406.144007. PMID 17367287.
7. Rogers SJ, Vismara LA (2008). "Evidence-based comprehensive treatments for early autism". J Clin Child Adolesc Psychol 37 (1): 8–38.

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It is natural for parents to want information on their child's long term prospects, or prognosis, with Autism or Asperger's syndrome. This can be difficult to predict, especially at younger ages.