LONG TERM OUTCOME WITH
Parents understandably want to know how their
child with autism
will cope in the future. However autism,
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
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
Adults with PDD/NOS
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.
DIFFICULTY PREDICTING THE FUTURE WHEN YOUNG
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. Children recover occasionally, sometimes
after intensive treatment and sometimes not; it is not known how
often this happens. 
Although core difficulties remain, symptoms often
become less severe in later childhood. 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. 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. 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. A 2005 Swedish
study of 78 adults that did not exclude low IQ found worse prognosis;
for example, only 4% achieved independence. Changes in diagnostic
practice and increased availability of effective early intervention
make it unclear whether these findings can be generalized to recently
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.
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.
4. Tidmarsh L, Volkmar FR (2003). "Diagnosis and epidemiology
of Autism Spectrum Disorders". Can J Psychiatry 48 (8): 517–25.
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.
7. Rogers SJ, Vismara LA (2008). "Evidence-based comprehensive
treatments for early autism". J Clin Child Adolesc Psychol
37 (1): 8–38.
Click here for the full
range of autism and Asperger's fact sheets at www.autism-help.org
This autism fact sheet is licensed under the GNU
Free Documentation. It is derivative of autism and Aspergers--related articles at http://en.wikipedia.org