Could My Child Outgrow Autism?

Is It Possible to Grow Out of Autism?

teens
teens. teens

From time to time, stories emerge of individuals who appear to have simply "outgrown" an early diagnosis of autism. Could these stories be true?

Officially, the Answer Is "No"

According to the DSM-5 (the diagnostic manual that currently describes mental and developmental disorders in the United States and many other nations), the answer is no.

That's because, according to the manual: "Manifestations of the social and communication impairments and restricted/repetitive behaviors that define autism spectrum disorder are clear in the developmental period. In later life, intervention or compensation, as well as current supports, may mask these difficulties in at least some contexts. However, symptoms remain sufficient to cause current impairment in social, occupational, or other important areas of functioning." 

In other words, says the DSM, autistic symptoms start early and continue throughout life, though adults may be able to "mask" their symptoms -- at least in some situations. They may also have been misdiagnosed to begin with because of autism-like symptoms related to late speech, unusual reading skills (hyperlexia), or social awkwardness. But according to the DSM it is impossible to "grow out" of autism. 

Treatment Can Radically Improve Symptoms

While children with autism don't appear to just "get better," most do improve over time with therapies and maturity. Some improve a great deal.

Consider this fairly common situation:

A child avoids eye contact, has difficulty with social communication, exhibits repetitive behaviors, dislikes any kind of change, and has sensory challenges, and so he is diagnosed with autism spectrum disorder.

Then, that child receives intensive therapies and matures.

Now, as a teen or adult, the same person may do a fine job making eye contact.

He may be only mildly delayed relative to social communication. Perhaps he has expanded his interests, and learned to manage his sensory challenges. No, he's not the homecoming king. Yes, he needs more help than the average person with "reading" a social situation. But if he were evaluated today, his symptoms would not rise to the level of an autism spectrum diagnosis.

 

Which Children Are Most Likely to Radically Improve?

Every now and then, a child with relatively severe symptoms improves to the point where he or she is able to function in a typical school setting. But this is extremely rare.

The reality is that the children who are most likely to radically improve are those whose symptoms are already relatively mild and do not include issues such as seizures, speech delay, learning disabilities, or severe anxiety. In general, therefore, the children most likely to "outgrow" autism are those with normal or above normal IQ's, spoken language skills, and other existing strengths. 

It's important to note, though, that leaving behind an autism spectrum diagnosis isn't the same thing as becoming "normal." Even very high functioning children with appear to "outgrow" their autism diagnosis still struggle with a variety of issues. They are still likely to have sensory challenges, social communication difficulties, anxiety, and other challenges, and may well wind up with diagnoses such as ADHD, OCD, social anxiety, or the relatively new Social Communication Disorder.

What Is the Difference Between "Outgrowing" and "Radically Improving?"

By the book (the DSM, to be precise), anyone who was every correctly diagnosed with autism will always be autistic, even they do not appear to have the symptoms of autism.

The fact that they are not showing any significant symptoms is a testament to their ability to "mask" or "manage" their challenges. This interpretation is shared by many functional adults who were diagnosed with autism as children. They say "inside I'm still autistic -- but I've learned to change my behaviors and manage my feelings." In other words, there is some basic difference that makes autistic people autistic -- and that basic difference doesn't go away, even if behavioral symptoms disappear.

Then there are those who have a very different point of view. Their perspective: if a person no longer exhibits sufficient symptoms for an autism diagnosis, then she has outgrown (or been cured of) autism.

In other words, the therapies worked and the autism is gone.

Who is right? When symptoms are no longer apparent to an outside observer, have they been "outgrown?" "cured?" "masked?" 

As with so many things related to autism, there is no absolutely correct answer to this question.  And the uncertainty extends into the professional realm. Yes, there are practitioners who will remove the autism label, saying "the autism is gone." And yes, there are practitioners who will keep the label, saying "autism never truly disappears, though its symptoms may not be evident."  By choosing your practitioner carefully, you may be able to get the answer you prefer!

A Word From Verywell

Parents of children with autism are often overwhelmed with information about "cures" that range from the silly to the extremely risky. These so-called cures are based on theories about autism that are not supported by research. It's very important to differentiate between treatments that can and should help your child, and those that have the potential to harm him or her.

Therapies such as ABA, Floortime, play therapy, speech therapy, and occupational therapy can all make a positive difference for your child, as can medications to mitigate anxiety, manage seizures, and improve sleep. Treatments such as chelation, hyperbaric oxygen chambers, bleach enemas and the like are not only ineffective: they are extremely risky.

While hope (and celebration of small victories) is always important, so, too, is common sense.

Sources

Close, Heather et al. Co-occurring conditions and change in diagnosis in autism spectrum disorders. Pediatrics Jan 2012, peds.2011-1717; DOI: 10.1542/peds.2011-1717

Eigstia, Inge-Marie. Language comprehension and brain function in individuals with an optimal outcome from autism. Neuroimage:Clinical. September, 2015

Treffert, Darold. Outgrowing autism? A closer look at children who read early or speak late. Scientific American, December 9, 2015

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