New Study Suggests Some Children May “Grow Out” Of Autism Diagnosis

There are several different diagnoses that all fall under the umbrella of autism spectrum disorders (ASD). While ASD isn’t fully understood, its prevalence is on the rise in the U.S. in recent years; as many as 1% of children may be diagnosed with some form of ASD (per the CDC), though researchers debate whether the rate increase is the result of increased prevalence or simply increased diagnosis. One factor that complicates ASD, both with regard to diagnosis and therapy, is that several other conditions often co-occur with autism. These include ADHD, learning disability, speech delay, and psychiatric conditions. It’s not clear whether ASD increases the likelihood of having a co-occurring condition, whether the opposite is true, or whether a third factor affects both the autism and the co-occurring condition. Regardless, awareness and understanding of co-occurring conditions is important to diagnosing and treating ASD effectively.

A new study published in Pediatrics (Close et al) suggests that co-occurring conditions may help health care practitioners to predict whether a child who is diagnosed with ASD will maintain the diagnosis as they age. It appears that some children “grow out” of their autism (or more accurately, grow out of the diagnosis of autism). According to the National Survey of Children’s Health, 40% of children who had at one time been diagnosed as autistic were no longer considered to have ASD at the time the parent responded to the health survey (Kogan et al). This can’t be taken to mean that 40% of children eventually outgrow autism; it’s possible (probable) that some of these children were originally misdiagnosed. It’s even possible that some of the children were incorrectly diagnosed as no longer having ASD. Still, the results of the Kogan study are interesting and are part of what prompted Close and colleagues to look at the differences between children whose diagnoses changed over time and those whose diagnoses did not change.

Looking at a group of 1366 children (who had been included in the National Survey of Children’s Health) between the ages of 3 and 17 years, Close and colleagues catalogued the co-occurring diagnoses that accompanied ASD, and determined whether co-occurring conditions were associated with changing ASD diagnosis status. They found that children aged 3-5 with current ASD were 11 times as likely to have a learning disability and 9 times as likely to have a developmental delay as children age 3-5 with a “past, but not current” (PBNC) autism diagnosis (meaning children who were once diagnosed with autism, but were no longer considered autistic at the time of the survey). These results are interesting, but it’s worth noting that because autism is quite difficult to diagnose in very young children, the sample size for these youngest individuals was very small. This suggests (albeit weakly) that children with learning disability and/or developmental delay are less likely to “outgrow” their autism diagnosis than children without these co-occurring conditions.

For children aged 6-11, Close and colleagues found that those with current ASD were nearly 4 times as likely to have had a past speech problem, 3.5 times as likely to have a current anxiety problem, and only one-fifth as likely to have had a past hearing problem as PBNC children. This suggests that children with speech and/or anxiety problems are less likely to “outgrow” their autism diagnosis than children without these conditions. Further, children with hearing problems and an autism diagnosis are five times MORE likely to “outgrow” their autism diagnosis than those without hearing problems. It may be that hearing difficulties can lead to autistic-appearing behavior (lack of communication, lack of engagement, lack of appropriate social interaction) without true underlying autism. Correcting the hearing problem could then reverse the “autistic” behavior and change the diagnosis.

Adolescents age 12-17 with current ASD were nearly 4 times more likely to have speech problems, 10 times more likely to have seizures and/or epilepsy, and only one-tenth as likely to have had a past hearing problem as those with PBNC ASD diagnoses. This suggests that children with speech problems and/or seizures/epilepsy are less likely to “outgrow” their autism diagnosis than children without these conditions. Further, it strengthens the association between resolving hearing problems and eventually “outgrowing” an autism diagnosis.

It’s important not to make too much of any one study, but this research certainly highlights some of the complexities associated with the diagnosis of autism. As researchers learn more about ASD, health care practitioners will be able to diagnose children more accurately. It remains to be seen whether children can ACTUALLY outgrow autism; it’s entirely possible that this study indicates that some children are incorrectly diagnosed with autism early in life, and that it becomes clear later on that they don’t actually have ASD. Time and more research will provide more robust answers.

 

Science Bottom Line:* It’s not possible to draw firm conclusions from this study, but it does shed some light on which children might eventually see some improvement in autistic behavior and/or no longer be considered autistic. These children include those who do not have speech, developmental, or psychological problems, and who DO have hearing problems (as long as those hearing problem are corrected).

 

Do you think some kids can “outgrow” autism?

 

References:

Centers for Disease Control and Prevention (CDC). Prevalence of autism spectrum disorders – Autism and Developmental Disabilities Monitoring Network, United States, 2006. MMWR Surveill Summ. 2009 Dec 18;58(10):1-20.

Close et al. Co-occurring Conditions and Change in Diagnosis in Autism Spectrum Disorders. Pediatrics 2012 Jan 23;129(2): DOI: 10.1542/peds.2011-1717.

Kogan et al. Prevalence of parent-reported diagnosis of autism spectrum disorder among children in the US, 2007. Pediatrics. 2009 Nov;124(5):1395-403. Epub 2009 Oct 5.

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3 Comments (+add yours?)

  1. Lisa
    Jan 28, 2012 @ 15:46:25

    I don’t think that kids grow out of autism so much as some are jut miss diagnosed. I have a friend who insists her son has autism, and she seeks all kinds of attention from her friends with the “woe is me” attitude. I’ve observed this boy, and he is no different than the two boys I raised. She has raised girls, boys are just different.

    My comment is in no way meant to put down a true diagnosis of Autism because it is very real.

    Reply

    • SquintMom
      Jan 28, 2012 @ 18:01:01

      I put the phrase “grow out” in quotes for exactly the reason you state; I think the health care field is still in the process of learning to understand and diagnose autism, and there are growing pains associated with this process. Certainly, some children will be misdiagnosed until autism is better understood and more rigorously defined. While it’s possible that some truly autistic (if it were possible to know the “ultimate” truth) kids do grow out of autism in a real sense, I suspect that the vast majority of kids who “grow out” of autism were never autistic to begin with. However, this study is nevertheless quite useful, because it helps parents, caregivers, health practitioners, and so forth to identify those kids who, while they might currently be diagnosed as having ASD, might one day no longer be considered autistic.

      Reply

  2. Seri Mengasih Centre
    Apr 21, 2012 @ 03:59:50

    Clinical neuroscientist, Dr Aditi Shankardass has this to say -> quote “It is estimated that one in six children suffer from developmental disorders, including…..
    autism…..However, despite the fact that all these disorders originate in the brain, most of them are diagnosed solely by looking at behavioural symptoms and without ever looking at the brain! That is to say, they are diagnosed behaviourally rather than neurologically. This often results in an incomplete or inaccurate diagnosis.” unquote
    check out this link on her work
    https://sites.google.com/site/aditishankardass/

    Reply

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