Nav: Home

Some children can 'recover' from autism, but problems often remain

March 12, 2019

Bronx, NY--(March 12, 2019)--Research in the past several years has shown that children can outgrow a diagnosis of autism spectrum disorder (ASD), once considered a lifelong condition. In a new study, researchers at Albert Einstein College of Medicine and Montefiore Health System have found that the vast majority of such children still have difficulties that require therapeutic and educational support. The study was published online today in the Journal of Child Neurology.

"It's certainly encouraging to confirm that a subset of children with early ASD diagnosis accompanied by developmental delays can in essence recover from the disorder and go on to have typical social and cognitive functioning," said lead author Lisa Shulman, M.D., professor of pediatrics at Einstein and interim director of the Rose F. Kennedy Children's Evaluation and Rehabilitation Center (CERC) at Montefiore. "But by and large, these children continue to struggle with daily life. Almost all of them still have to contend with language and learning disabilities and a variety of emotional and behavioral problems."

In the study, Dr. Shulman and her colleagues reviewed clinical records of 569 patients who were diagnosed with ASD between 2003 and 2013 at CERC, a university-affiliated early intervention program in the Bronx for children with developmental disabilities. Their mean age was 2½ years at initial diagnosis and 6½ years at follow up. The vast majority had received early intervention services, a mix of speech and occupational therapies, special instruction, and applied behavioral analysis (the main evidence-based treatment for ASD).

At follow-up, 38 children (seven percent of the original 569 patients) no longer met the diagnostic criteria for ASD. Of these 38 children, 68 percent were diagnosed with language or learning disabilities; 49 percent with externalizing behavior problems (attention-deficit/hyperactivity disorder, oppositional defiant disorder, or disruptive behavior disorder); 24 percent with internalizing behavior problems (mood disorder, anxiety disorder, obsessive compulsive disorder, or selective mutism); and 5 percent with a significant mental health diagnosis (psychotic disorder not otherwise specified).

Only three (8 percent) of the 38 children recovered from ASD and had no other problems. Follow-up cognitive testing (available in 33 of the 38 participants) showed that none of the children was intellectually disabled.

"Our findings beg the question, what is going on with these children who no longer have an ASD diagnosis?" said Dr. Shulman. "Was autism initially over-diagnosed? Are some children better able to respond to intervention? Does the specific intervention the child receives contribute to outcome? Our sense is that some children with ASD respond to intervention while others have unique developmental trajectories that lead to improvement. Those children who evolve in a positive direction generally have the mildest symptoms to begin with."

The current study is the largest of its kind with the most rigorous diagnostic follow up. "The message from our study is that some of our kids do amazingly well, but most of them have persistent difficulties requiring ongoing monitoring and therapeutic support," said Dr. Shulman.
-end-
The study is titled, "When an Early Diagnosis of Autism Spectrum Disorder Resolves, What Remains?" The other contributors are: Maria D.R. Valicenti-McDermott, M.D., and Rosa Seijo, M.D., both of Einstein-Montefiore; and Erin D'Agostino, M.D.; Samantha Lee; Elizabeth Tulloch, Ph.D.; Deborah Meringolo, M.A., M.S.; and Nancy Tarshis, M.A., M.S., all formerly of Einstein-Montefiore.

No funding was received to support this research. None of the authors report any conflicts of interest.

About Albert Einstein College of Medicine

Albert Einstein College of Medicine, part of Montefiore, is one of the nation's premier centers for research, medical education and clinical investigation. During the 2018-2019 academic year, Einstein is home to 711 M.D. students, 160 Ph.D. students, 107 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,800 full-time faculty members located on the main campus and at its clinical affiliates. In 2018, Einstein received more than $172 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States through Montefiore and an affiliation network involving hospitals and medical centers in the Bronx, Brooklyn and on Long Island. For more information, please visit http://www.einstein.yu.edu, read our blog, follow us on Twitter, like us on Facebook and view us on YouTube.

Albert Einstein College of Medicine

Related Autism Spectrum Disorder Articles:

Studies of autism spectrum disorder reveal new avenues of neuroscience research
Advances in the study of cognitive disorders, including Autism Spectrum Disorder (ASD), may pave the way for future treatments.
Autism spectrum disorder risk linked to insufficient placental steroid
A study led by Children's National Hospital and presented during Neuroscience 2019 finds that loss of allopregnanolone, a key hormone supplied by the placenta, leads to long-term structural alterations of the cerebellum -- a brain region essential for smooth motor coordination, balance and social cognition -- and increases the risk of developing autism.
The Lancet Psychiatry: Compensatory strategies to disguise autism spectrum disorder may delay diagnosis
For the first time, compensatory strategies used by people with autism have been investigated and collated in a qualitative study using an online survey of 136 adults, published in The Lancet Psychiatry journal.
Exercise fine-tunes brain's connections, eases autism spectrum disorder in mouse model
A mouse model of autism has revealed how exercise changes the structure of the brain by eliminating the excess connections between neurons characteristic of autism spectrum disorder (ASD).
New approaches to study the genetics of autism spectrum disorder may lead to new therapies
Autism spectrum disorder (ASD) is highly variable disorder, both in its presentation and in its genetics -- hundreds of risk genes have been identified.
A step toward better understanding brain anatomy of autism spectrum disorder
A new study, led by researchers at McGill University's Faculty of Medicine and the Douglas Mental Health University Institute, set out to settle some of the discrepancies related to brain anatomy and ASD, employing a large dataset to obtain their findings.
Modulating a hormonal pathway improves social function in 2 clinical trials of adults and children with autism spectrum disorder
Results from two clinical trials reveal that modulating the hormone vasopressin's biological pathway safely enhanced social functioning in 223 adult men and 30 children with autism spectrum disorder (ASD).
Does wearable behavioral intervention improve social behavior in kids with autism spectrum disorder?
This randomized clinical trial of 71 children with autism spectrum disorder (ASD) tested a wearable behavioral intervention deployed on Google Glass and worn by children at home to reinforce facial engagement and emotion recognition to improve social behavior.
Early exposure to pesticides linked to small increased risk of autism spectrum disorder
Exposure to common agricultural pesticides before birth and in the first year of life is associated with a small to moderately increased risk of autism spectrum disorder (ASD) compared with infants of women without such exposure, finds a study published in The BMJ today.
Is prenatal vitamin use by moms associated with risk for autism spectrum disorder recurrence in young siblings?
This study examined whether prenatal vitamin use by mothers was associated with autism spectrum disorder (ASD) recurrence in high-risk families.
More Autism Spectrum Disorder News and Autism Spectrum Disorder Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Accessing Better Health
Essential health care is a right, not a privilege ... or is it? This hour, TED speakers explore how we can give everyone access to a healthier way of life, despite who you are or where you live. Guests include physician Raj Panjabi, former NYC health commissioner Mary Bassett, researcher Michael Hendryx, and neuroscientist Rachel Wurzman.
Now Playing: Science for the People

#544 Prosperity Without Growth
The societies we live in are organised around growth, objects, and driving forward a constantly expanding economy as benchmarks of success and prosperity. But this growing consumption at all costs is at odds with our understanding of what our planet can support. How do we lower the environmental impact of economic activity? How do we redefine success and prosperity separate from GDP, which politicians and governments have focused on for decades? We speak with ecological economist Tim Jackson, Professor of Sustainable Development at the University of Surrey, Director of the Centre for the Understanding of Sustainable Propserity, and author of...
Now Playing: Radiolab

An Announcement from Radiolab