Autism natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Prognosis
There is no cure. Children recover occasionally, sometimes after intensive treatment and sometimes not; it is not known how often this happens. Most children with autism lack social support, meaningful relationships, future employment opportunities or self-determination.[1] 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 ASD with a high level of support and very limited autonomy, and 12% needed high-level hospital care.[5] A 2005 Swedish study of 78 adults that did not exclude low IQ found worse prognosis; for example, only 4% achieved independence.[6] A 2008 Canadian study of 48 young adults diagnosed with ASD as preschoolers found outcomes ranging through poor (46%), fair (32%), good (17%), and very good (4%); only 56% had ever been employed, most in volunteer, sheltered or part time work.[7] Changes in diagnostic practice and increased availability of effective early intervention make it unclear whether these findings can be generalized to recently diagnosed children.
References
- ↑ 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.
- ↑ Howlin P (2006). "Autism spectrum disorders". Psychiatry. 5 (9): 320–4. doi:10.1053/j.mppsy.2006.06.007.
- ↑ Seltzer MM, Shattuck P, Abbeduto L, Greenberg JS (2004). "Trajectory of development in adolescents and adults with autism" (PDF). Ment Retard Dev Disabil Res Rev. 10 (4): 234–47. doi:10.1002/mrdd.20038. PMID 15666341. Retrieved 2008-04-17.
- ↑ Tidmarsh L, Volkmar FR (2003). "Diagnosis and epidemiology of autism spectrum disorders". Can J Psychiatry. 48 (8): 517–25. PMID 14574827.
- ↑ 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.
- ↑ 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.
- ↑ Eaves LC, Ho HH (2008). "Young adult outcome of autism spectrum disorders". J Autism Dev Disord. 38 (4): 739–47. doi:10.1007/s10803-007-0441-x. PMID 17764027.