Optimal outcome and autism

scienceAlthough united by the core clinical features which make up a diagnosis of autism or autism spectrum disorder (ASD), there is quite widespread acceptance about a significant degree of diversity among the presentation of autism. This heterogeneity, further clouded by the impact of various different comorbidities occurring alongside cases, has done little to progress research to the point of being able to elucidate common genetic or biological pathways which might underpin the presentation of symptoms and offer suitable tools to improve quality of life where and when required.

Moves towards a more plural view of autism – the autisms – as a function of such heterogeneity continue to gather pace, not least because of an emerging body of research suggestive of differing developmental trajectories to be present in subgroups of people on the autism spectrum. The paper by Deborah Anderson and colleagues* further adds to this area with their recent results looking at outcome and autism in the medium- and long-term. Spanning 17 years of research, this most recent report from Anderson looked at various measures of autism-related behaviours and cognitive abilities in young adults with autism aged 19 years. Based on comparisons with similar results for participants taken when aged 2 years old, the authors were able to examine which factors in early infancy may have affected later outcome.

Their results suggested that reports of verbal and non-verbal cognitive abilities measured at aged 2 years were able to quite accurately predict a person’s level of intellectual disability when aged 19. Further the authors reported that a proportion of their participants had, by early adulthood, largely overcome most of their measured core autism symptoms and “lost” their diagnosis. This may also have been linked to an effect from early intervention.

Further work is required to substantiate these findings and provide more detail about those reported as showing optimal outcome. Elucidating further characteristics of potential best responders to early intervention alongside any biological or genetic correlates might also provide important details.


* Anderson DK. et al. Predicting young adult outcome among more and less cognitively able individuals with autism spectrum disorders. J Child Psychol Psychiatry. 2013 Dec 9. doi: 10.1111/jcpp.12178.

Further commentary on this study can be found at: http://questioning-answers.blogspot.com/2014/02/optimal-outcome-autism-by-any-other-name.html