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A follow-up study of high-functioning autistic children
P Szatmari1, G Bartolucci, R Bremner
1Department of Psychiatry, Chedoke-McMaster Hospitals, McMaster University, Ontario, Canada.
Insights
Most autistic children without intellectual disability do not achieve good adult outcomes. However, a surprising number recover substantially, with nonverbal problem-solving skills predicting better results.
Area of Science:
- Neuroscience
- Developmental Psychology
- Child Psychiatry
Background:
- Intellectual Quotient (IQ) is a known predictor of outcomes in autistic children.
- Limited data exists on the long-term adult outcomes of autistic individuals without intellectual disability.
- Understanding adult trajectories is crucial for early intervention and support.
Purpose of the Study:
- To investigate the long-term occupational, social, and psychiatric outcomes of adults who were diagnosed with autism in childhood and did not have intellectual disability.
- To identify predictors of successful outcomes in this specific population.
Main Methods:
- A retrospective follow-up study of 16 adults (12 males, 4 females; mean age 26, mean IQ 92) diagnosed with autism and without intellectual disability.
- Data collected on occupational-social functioning and psychiatric symptoms.
- Neuropsychological measures, including nonverbal problem-solving, were assessed.
Main Results:
- The majority of participants exhibited poor occupational-social functioning and persistent psychiatric symptoms.
- A notable minority (4 out of 16) achieved a very good outcome, suggesting potential recovery.
- Early autistic behavior severity was not a strong predictor of adult outcome.
- Neuropsychological measures of nonverbal problem-solving demonstrated a strong correlation with long-term outcomes.
Conclusions:
- A small percentage of autistic children without intellectual disability can achieve substantial recovery in adulthood.
- Nonverbal problem-solving abilities appear to be a more reliable predictor of positive outcomes than early behavioral severity.
- Further research into the factors contributing to recovery in this population is warranted.
Abstract:
It is well known that IQ is an important prognostic variable in the outcome of autistic children. There are, however, very few data available on the outcome of nonretarded autistic children as adults. We identified 16 such probands from records and followed them up between 11 and 27 years since discharge from a center specializing in the assessment of autistic children. There were 12 males and 4 females, average age was 26, and mean IQ was 92 (range 68-110). Although the majority were functioning poorly in terms of occupational-social outcome and psychiatric symptoms, a surprising number (4) had a very good outcome and might be considered recovered. The severity of early autistic behavior was a poor predictor of outcome, but neuropsychologic measures of nonverbal problem solving were highly correlated with outcomes. The results of the study indicate that a small percentage of nonretarded autistic children can be expected to recover to a substantial degree.