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Saturday, August 23, 2014
If a child has moderate Autism does the child become normal after a specified age or improve with age?
The answer partly depends on what one considers "normal," and partly on the severity of symptoms and what treatment the child receives.
In the old days, when only the most severe and obvious cases, usually with intellectual disability (new term for mental retardation), were diagnosed, the prognosis was very poor. But even then, it was noted that those with normal IQ and some speech by age 5 sometimes would be able to become self-supporting in occupations where they did not have to interact with people very much.
The modern liberalization of diagnostic criteria has brought into the diagnostic fold milder cases with higher IQ and a much better prognosis. I have personally seen a number of such children move from obvious autism to a status that on casual acquaintance does not suggest autism. This may be partly due to better-prognosis cases being diagnosed, but is also undoubtedly due to intensive behavioral treatment, and in some cases to treatment of associated symptoms with medication.
Treatment does seem to help and progress is possible, so parents and other caregivers should keep plugging away even though at times it seems discouraging. The most symptomatic time is usually about age 4-5, and symptoms often improve after that, especially with treatment. Although not all such children will become completely normal, there is enough hope that it is important to take the long view and work toward goals.
L Eugene Arnold, MD, MEd
Professor Emeritus of Psychiatry
College of Medicine
The Ohio State University