Optimal outcome in individuals with a history of autism
Open accessAbstract
Background: Although autism spectrum disorders (ASDs) are generally considered lifelong disabilities, literature suggests that a minority of individuals with an ASD will lose the diagnosis. However, the existence of this phenomenon, as well as its frequency and interpretation, is still controversial: were they misdiagnosed initially, is this a rare event, did they lose the full diagnosis, but still suffer significant social and communication impairments or did they lose all symptoms of ASD and function socially within the normal range? Methods: The present study documents a group of these optimal outcome individuals (OO group, n = 34) by comparing their functioning on standardized measures to age, sex, and nonverbal IQ matched individuals with high‐functioning autism (HFA group, n = 44) or typical development (TD group, n = 34). For this study, ‘optimal outcome’ requires losing all symptoms of ASD in addition to the diagnosis, and functioning within the nonautistic range of social interaction and communication. Domains explored include language, face recognition, socialization, communication, and autism symptoms. Results: Optimal outcome and TD groups’ mean scores did not differ on socialization, communication, face recognition, or most language subscales, although three OO individuals showed below‐average scores on face recognition. Early in their development, the OO group displayed milder symptoms than the HFA group in the social domain, but had equally severe difficulties with communication and repetitive behaviors. Conclusions: Although possible deficits in more subtle aspects of social interaction or cognition are not ruled out, the results substantiate the possibility of OO from autism spectrum disorders and demonstrate an overall level of functioning within normal limits for this group.
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A small subset of children with ASD may lose the diagnosis and reach an optimal outcome; such children probably have less severe symptoms and stronger cognitive skills.
“In addition, several recent studies have revealed that a small portion of children with ASDs may be able to progress sufficiently to lose their ASD diagnosis and attain an “optimal outcome”, and these children are likely to be those with relatively milder symptoms and higher cognitive functioning.”
From Sensitivity and Specificity of Proposed DSM-5 Criteria for Autism Spectrum Disorder in Toddlers (2013) · cites this paper as Fein et al., 2013
There are contrasting views on the strength of the evidence for universal population-wide testing for ASD.
“However, there are contrasting views on the strength of the evidence for universal population-wide testing 145,146”
From Autism spectrum disorder (2020) · cites this paper as [146]
The Method (Participants and Measures; page unavailable) describes screening and diagnostic assessment of study participants, not universal population-wide ASD testing. The Discussion (page unavailable) addresses outcomes after an ASD diagnosis. Searches for population-wide screening and disagreement about its evidence found no passage addressing the claim. (LLM, conf=0.78)
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- Authors
- Fein, D., Barton, M., Eigsti, I., Kelley, E., Naigles, L., Schultz, R. T., Stevens, M., Helt, M., Orinstein, A., Rosenthal, M., Troyb, E., & Tyson, K.
- Affiliations
- University of Connecticut (US)
- Queen's University (CA)
- Children's Hospital of Philadelphia (US)
- Hartford Hospital (US)
- Child Mind Institute (US)
- ORCID
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2013-01-16
- Volume
- 54
- Issue
- 2
- Pages
- 195-205
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC3547539
- OpenAlex
- W2145215768
- Cited by
- 584
- References
- 41
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 28 · 2023: 31 · 2022: 40 · 2021: 85 · 2020: 60 · 2019: 44 · 2018: 41 · 2017: 43 · 2016: 43 · 2015: 63 · 2014: 47 · 2013: 27
- FWCI
- 32.78
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (R01MH076189)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- autism spectrum disorder, optimal outcomes, high-functioning autism, social functioning, communication, face recognition (cognition), social interaction, repetitive behavior, language development
- MeSH terms
- Adolescent, Age Factors, Autistic Disorder, Child, Female, Humans, Interview, Psychological, Male, Psychiatric Status Rating Scales, Psychological Tests, Surveys and Questionnaires, Remission, Spontaneous, Sex Factors, Wechsler Scales, Young Adult
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