You have likely heard of autism. According to the Centers for Disease Control, the neurobehavioral condition affects an estimated 1 in 59 children in the United States alone.
Autism causes impairments in social interaction, language, and communication combined with rigid, repetitive behaviors. But there is not just one type of autism.
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The symptoms vary significantly from case to case. That is why the condition is referred to as autism spectrum disorder (ASD).
ASD has been considered for a long time a lifelong condition. However, new research from the past several years is bringing hope that children can outgrow the diagnosis.
"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.
The study, the largest of its kind with the most rigorous diagnostic follow up, examined clinical records of 569 patients who were diagnosed with ASD between 2003 and 2013 at CERC. The patients had a mean age of 2½ years at initial diagnosis and 6½ years at follow up.
The majority had received early intervention services of evidence-based treatment for ASD. It turned out that at the end of the experimental period, 38 children no longer met the diagnostic criteria for ASD.
That is not to say however that they were completely symptom-free. "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," explained Shulman.
Indeed, the researchers reported that of the 38 children, many still struggled with language, learning, and both externalizing and internalizing problems. Only three of the 38 children recovered from ASD were reported to have no other problems.
What is going on?
"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."
In the end, the researchers concluded that while some of the patients did remarkably well, the rest still need continued help.
"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.
The study was published online today in the Journal of Child Neurology.