Autism is a developmental disorder with no cure, but studies have shown some children seem to “grow out” of their autism diagnosis. How is this possible?
Autism is a spectrum disorder, meaning that there are different ranges of severity. Children with mild symptoms who are diagnosed early can sometimes learn how to manage symptoms so effectively that it seems like they no longer have the disorder at all.
In these children, their autism symptoms are likely not gone completely. Rather, the child has learned how to compensate for, or mask, the symptoms of the disorder.
In some cases where it seems as if the autism has disappeared, other disorders can manifest in its place. But this doesn’t mean that the child grew out of autism and into another disorder. Most often, the original condition was misdiagnosed in the first place.
Can You Grow Out of Autism?
The short answer is no. Autism is a lifelong diagnosis, and there is no known cure.
As a spectrum disorder, there are varying degrees of autism and levels of disability. Some children with milder symptoms can learn how to manage the disorder more effectively than others.
Autism impacts communication, behavior, emotion, and social skills. The earlier it is diagnosed, the more effectively a child can learn how to improve these skills through early intervention techniques.
There have been several studies documenting that between 3% and 25% of children diagnosed with autism seem to grow out of their diagnoses. These children were often diagnosed young. In follow-ups, they show no characteristics of the disorder later in life. This is called an optimal outcome, or OO.
Other studies show that children in the OO group who were diagnosed with autism before 5 years old, and tested through the standard autism diagnostic test and personality tests, no longer show social characteristics of autism. These children no longer fall into the diagnostic parameters of autism.
There are several possible reasons for this outcome. It does not mean that a child can truly outgrow an autism diagnosis.
Study Limitations & Possible Conclusions
There are limitations to these studies that affect how we can interpret the results.
Misdiagnosis: A possible reason for a change in an autism diagnosis is that a child was misdiagnosed in the first place. Many of the studies used a child’s prior medical records to verify that the child has autism. The child’s diagnosis is not verified through separate testing and assessment. Children can be diagnosed with autism as young as 18 months old, but many of the developmental delays that indicate autism can even out by age 2 or so. Because of this, an autism diagnosis is often not considered stable until at least age 2. Children who are diagnosed too early can be misdiagnosed.
Higher innate cognitive abilities: Children in the autism studies who achieve the optimal outcome often begin with a higher level of cognitive abilities and higher IQs than what is considered standard. These children are potentially better equipped to learn how to manage autism and observe social cues to mask their autistic symptoms later in life. Many children have mild symptoms that go unnoticed until they start school. Social pressures become too overwhelming, and these mild symptoms may begin to show. These children didn’t suddenly develop autism. They have merely been hiding their symptoms. They developed coping skills on their own (often due to their higher cognitive abilities) that worked up until this point.
Additional issues: Children who seem to shed the autism diagnosis and fall into the OO category regularly struggle with learning and language disabilities as well as behavioral and emotional problems. Children who were initially diagnosed with autism at a young age can seem to normalize socially and intellectually, but they frequently have difficulties with attention (often leading to a diagnosis of attention deficit hyperactivity disorder), abnormal thinking patterns, poor executive functions, depression, sleep issues, gastrointestinal problems, seizures, and anxiety. Emotional regulation issues also persist. While these children seem to have “recovered” from autism, they will need therapeutic support and continued monitoring as behavioral, emotional, and language issues are still present. Again, it is often thought that these children may have been initially misdiagnosed with autism instead of other developmental, behavioral, or mental health disorders.
Symptom Management for Optimal Outcome
While an autism diagnosis is generally not considered reliable before age 2, the earlier the disorder is suspected, and the sooner interventions begin, the better the long-term outcome. Children who are diagnosed early and begin treatment as soon as possible can learn effective coping skills. This can help them to manage their symptoms to such a degree that it may seem like they no longer struggle with autism at all.
Remember that autism is a lifelong disorder. Children do not actually outgrow it. However, if the symptoms are mild enough, the disorder can sometimes have little to no impact on daily life functioning.
A recent clinical report found that about 9% of children who were diagnosed with autism early did not meet the autism diagnostic criteria in early adulthood. Children with the highest chance of “losing” their autism diagnosis:
Are diagnosed young.
Have higher cognitive and language skills at age 2.
Receive early intervention services.
Report decreased repetitive behaviors over time.
Early intervention and diagnosis are key for helping children learn how to manage symptoms, acquire important life skills, and improve developmental delays and behavioral issues. Additionally, therapy and early intervention can help autistic children develop necessary communication and social skills to improve autistic symptoms, potentially even to a point where they no longer meet the diagnostic criteria for autism.
Even for those who seem to outgrow most of the symptoms of autism, continuing education, therapy, and ongoing monitoring are beneficial. Most of these children, and then adults, will still need support for some issues.
There is no question that early treatment is crucial. Children who receive support, therapy, and interventions early in life show the greatest odds for the highest quality of life in later childhood and beyond.
References
Treatment and Intervention Services for Autism Spectrum Disorder. (September 2019). Centers for Disease Control and Prevention (CDC).
What Is Autism Spectrum Disorder? (March 2020). Centers for Disease Control and Prevention (CDC).
Optimal Outcome in Individuals With a History of Autism. (January 2013). Journal of Child Psychology and Psychiatry.
Some Children May Truly Outgrow Autism. (October 2016). Spectrum.
What Is Autism? (2020). Autism Speaks.
How Early Can Autism Be Diagnosed? (March 2013). Autism Speaks.
Is It Possible for Children to ‘Grow Out’ of Autism? (January 2013). National Health Service (NHS).
Can People Really Grow Out of Autism? (January 2013). Forbes.
Some Children Can ‘Recover’ From Autism, but Problems Often Remain, Study Finds. (March 2019). Albert Einstein College of Medicine.
Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. (January 2020). Pediatrics.
Early Intervention for Autism is Important. My Son Is Proof of That. (December 2019). Washington Post.
