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Autism Outcomes
Autism symptoms are usually diagnosed during early childhood. However, the impairments of autism are considered to last a
lifetime, and continue to create challenges for the affected individual and his or her family. Adolescence is a time of stress and
confusion; and it is no less so for teenagers with autism. Like all children, they need help in dealing with their prepubescent
development.

While some symptoms of autism improve during the teenage years, some get worse. Increased autistic or aggressive behavior
may be one way some teens express their worries and embarrassment. The teenage years are also a time when children become
more socially sensitive. At the age that most teenagers are concerned with acne, popularity, grades, and dates, teens with autism
may become exceedingly aware that they are different from their peers. They may notice that they lack friends. And unlike their
schoolmates, they aren't dating or planning for a career. For some, the despair that comes with such realization motivates them
to learn new behaviors and gain better social skills. Despite its early emergence, autism is believed to be a lifelong condition;
however, little is known about the symptoms at the root of autism in adolescence and adulthood.

Studies on the Autism and Symptoms

Few studies address the developmental path of autism symptoms from childhood through adolescence and into adulthood. In
general, studies have focused on age related differences and changes in the severity of the symptoms of autism, asking (1)
whether symptoms decrease, remain stable, or become more severe over the life course and (2) whether individuals continue to
meet the diagnostic criteria for having an autism diagnosis after the early childhood years.

Studies regarding changes in autistic symptoms have extended four decades, and therefore they differ in the diagnostic
observation through time. Despite inconsistencies in diagnostic practices, as well as differences in plan, sample, and evaluation,
the gathered evidence signifies that the major symptoms of autism decrease to some degree during adolescence and young
adulthood. Recent studies provide a fine distinction in description of symptom change, suggesting that development may be
divided, with improvement in only some behaviors that characterize autism and with different timing of improvement in
behaviors.

In the course of progress in autistic symptoms during adolescence and adulthood, there can be a period of little or no growth or
decline. Even periods of aggravation along the way, and for some individuals, symptoms may not subside or even may worsen.
For example, in a study of 23 people between the ages of 16 and 23 years diagnosed with autism as part of a population
epidemiological survey (the field of medicine that deals with the study of the causes, distribution, and control of disease in
populations) it was found that 35% of the individuals experienced temporary (1-2 years) periods of frustration in behavioral
symptoms (aggression, hyperactivity, insistence on sameness), and 22% displayed continuing deterioration throughout puberty
in these same areas of behavior plus loss of language skills and cognitive abilities. A small percentage of individuals experienced
the onset of seizures in puberty. Improvement is typically seen in terms of the acquisition of new skills and a decline in difficult
behaviors.

Autism and Changes in Communication

Studies on autistic symptoms in communication show areas of improvements, though not seen for all individuals and even in
those who do improve, changes are rarely significant enough to move the individual into the normal range of functioning. Other
researchers have also documented the improving, but lasting, symptoms of autism.  There are also considerable differences in
the course of change in communicative behaviors. For example, speech symptoms that are the “classic” signs of autism (e.g.,
pronoun reversal, phrases) improve the most, whereas failure in pointing to express interest and use of gestures to communicate
are less likely to improve from childhood. Early language achievements have been found to be a predictor of outcomes in
adolescence and adulthood. Adults with autism who had better early language skills were more successful than those who had
little communication skills during childhood. A study found that the presence of social language at age 5 or 6 years contributed
to better outcomes in adolescence and adulthood.

Duration of Autistic Symptoms and Behavior

Studies on autistic symptoms and behavior have shown that few if any individuals who receive a diagnosis of autism in
childhood recover fully and achieve levels of functioning typical of their age peers. For example, one study used ratings of the
Childhood Autism Rating Scale (CARS) to decide on the appropriateness of the autism diagnosis in a clinical study of 59
adolescents, who as children had received an autism diagnosis also using the CARS. More than 80% of the children who met
criteria for autism before age 10 continued to do so after age 13, although the group as a whole showed improvement on most
features of behavior.

Retrospective studies on symptoms of autism provide a similar picture. In an analysis of 76 adolescents and adults with autism,
found that 82% of the individuals who qualified for a diagnosis of autistic disorder based on the retrospective reports of
caregivers still qualified based on responses about current functioning. Individuals who outgrow the ASD diagnosis are mainly
those who are initially diagnosed as having Asperger’s Syndrome or PDD-NOS. Even among those with high functioning
autism, however, most continue to meet criteria for the diagnosis in adolescence and adulthood. Change in diagnostic status
among more severely affected individuals may be less likely.

In all only a small percentage of individuals show improvement in autistic symptoms during the adolescent and adult years that
is of sufficient extent to prove the diagnosis of autism invalid. Those most likely to “outgrow” the diagnosis are those who as
children displayed the least severe symptoms. In fact, it is amazing that as many as between 10% and 20% outgrow the
diagnosis, as autism is perhaps among the most severe and persistent of the developmental disorders. However, given this
severity and frequency, its stability throughout the life course is not a surprising finding.

Autism Symptoms in Adulthood

Reports on autistic symptoms during adulthood show 72% of the adults with autism have little independence in basic daily living
skills. Few adults with autism live independently, marry, go to college, work in competitive jobs, or develop large network of
friends. The majority remain dependent on their families or professional service providers for assistance with tasks of daily
living. Even among those who work, jobs are often insufficiently paid and do not provide enough for their cost of living
expense. Furthermore, adults with autism tend to have poorer outcomes than others with disabilities. However, higher
functioning individuals are able to live independently, work in competitive jobs, and may have a network of social relationships.

Clinical research on improvements in autistic symptoms emphasize the importance of the family and formal service supports for
adults with autism. There is a growing research suggesting that casual support from family and friends is associated to better
outcomes for adults with psychiatric disabilities. It is quite possible that adequate functioning in adulthood for individuals with
autism may depend as much on the amount of support offered by families, friends, and service providers as on basic
intelligence and language skills. More research on the contributions of familial, formal supports and other methods used for
individuals with autism are important to develop new and effective interventions and services created for their unique needs in
adolescence and adulthood.
Autism Outcomes
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