Some Kids With Autism Show Improvement by Age 6: Study

20 percent experienced gains in daily functioning, 11 percent had less severe symptoms, researchers say

Wednesday, January 28, 2015

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WEDNESDAY, Jan. 28, 2015 (HealthDay News) -- More than 10 percent of preschool-age children diagnosed with autism saw some improvement in their symptoms by age 6. And 20 percent of the children made some gains in everyday functioning, a new study found.

Canadian researchers followed 421 children from diagnosis (between ages 2 and 4) until age 6, collecting information at four points in time to see how their symptoms and their ability to adapt to daily life fared.

"Between 11 and 20 percent did remarkably well," said study leader Dr. Peter Szatmari, chief of the Child and Youth Mental Health Collaborative at the Centre for Addiction and Mental Health in Toronto.

However, improvement in symptom severity wasn't necessarily tied to gains in everyday functioning, Szatmari said. Eleven percent of the children experienced some improvement in symptoms. About 20 percent improved in what experts call "adaptive functioning" -- meaning how they function in daily life. These weren't necessarily the same children, he said.

"You can have a child over time who learns to talk, socialize and interact, but still has symptoms like flapping, rocking and repetitive speech," Szatmari said. "Or you can have kids who aren't able to talk and interact, but their symptoms like flapping reduce remarkably over time."

The interplay between these two areas -- symptom severity and ability to function -- is a mystery, and should be the topic of more research, Szatmari said.

One take-home point of the research, Szatmari said, is that there's a need to address both symptoms and everyday functioning in children with autism spectrum disorder.

"If it were my kid, I would want adaptive functioning to improve and [feel] symptoms are less important," he said. "Adaptive functioning determines your place in the world."

Only 66 of the study participants were girls, and Szatmari found they had less severe symptoms and more improvement in symptoms than boys. The earlier the children were diagnosed, the more likely they were to show improvement in functioning, the study found.

The findings were published online Jan. 28 in the journal JAMA Psychiatry.

About 1 in 68 children in the United States is affected by autism spectrum disorder (ASD), and boys more so than girls, according to the U.S. Centers for Disease Control and Prevention. ASD is a group of developmental disabilities marked by social, communication and behavioral difficulties. Symptoms can range from mild to severe, and the condition is thought to be lifelong.

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center of New York in New Hyde Park, N.Y., called the new research well done and said it yielded some important points for parents and doctors.

"This study highlights not only the variability of autism symptom severity among young children with ASD, but also the variability in adaptive functioning such as self-care skills," said Adesman, who wasn't involved in the study.

For parents discouraged by the relatively small percentage of children in the study who showed improvement in either area, Adesman noted that kids diagnosed earlier with autism may be more severely affected. Also, parents shouldn't generalize the study findings to children who are older when diagnosed, as they may be less severely affected, he said.

Szatmari added that parents who suspect their child shows symptoms of autism, such as an inability to interact or speak properly, should seek an evaluation.

SOURCES: Peter Szatmari, M.D., chief, Child and Youth Mental Health Collaborative, Centre for Addiction and Mental Health, Toronto, Canada; Andrew Adesman, M.D., chief of developmental and behavioral pediatrics, Steven & Alexandra Cohen Children's Medical Center of New York, New Hyde Park, N.Y.; Jan. 28, 2015, Neurology

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