From Amy Norton
Tuesday, March 19, 2019 (HealthDay News) – Some toddlers thought mild autism outgrows the diagnosis, but most people continue to struggle with language and behavior, new research suggests.
The study is not the first to document cases of autism "recovery". Doctors have known for decades that a small number of young children diagnosed with autism spectrum disorder (ASD) seem to outgrow it.
But what does that mean for those children? The findings suggest that the vast majority are still facing challenges and need support, said lead researcher Dr. Lisa Shulman.
Her team discovered that of the 38 children who "lost" their diagnosis of autism, most were found to have other disorders – including learning disabilities, attention deficit hyperactivity disorder (ADHD) and anxiety disorders.
Why did the image for those children change?
That's the & # 39; million dollar question & # 39 ;, said Shulman, a professor of pediatrics at the Albert Einstein College of Medicine / Montefiore Health System in New York City.
One possibility is that the original diagnosis was wrong. But it is also possible that some children responded to early therapy to support their development.
Shulman suspects that both scenarios are true.
The 569 children in the study were diagnosed before the age of 3 years. And what looks like an autism in a two-year-old child can manifest itself differently as the child grows, Shulman explained. For example, the 2-year-old may have an anxiety disorder, but children of that age simply cannot express what they feel. It only becomes clearer when the child is a little older.
On the other hand, early behavioral therapy can help children with autism to build up their social and language skills and to reduce behavioral problems. So young children who respond may no longer meet the criteria for autism at some point.
"I think there is a group of children who will probably never get autism," Shulman said. "And there are some who respond to early intervention."
James Connell is the clinical director of the A.J. Drexel Autism Institute in Philadelphia. He agreed that it can be difficult for toddlers to determine if it is autism or something else.
"Global developmental delays, language delays and separation anxiety among 18- to 24-month-old children can resemble an ASD," said Connell, who was not involved in the study.
He even said, "I would argue that most if not all of these children did not have ASD."
But that does not mean that children who were wrongly given an autism label did not benefit from therapy. Connell said that early and intensive services can be very useful, not only for children with ASD, but also for people with developmental delays.
And in fact, Connell said, young children with developmental problems can receive an ASD diagnosis specifically, so that they are eligible for such intensive therapy.
"A diagnosis of autism receives services – services that these children need," he said. & # 39; Doctors know that, parents know that. & # 39;
The latest findings, recently published in the Journal of Child Neurology, were based on data from 569 children with autism at the center of the researchers between 2003 and 2013. Four years later, 38 of those children no longer met the diagnostic criteria.
They all had one thing in common, according to Shulman. They had what initially seemed milder symptoms; they were not at the heavier end of the spectrum.
And almost all of them saw their diagnoses evolve. A full 68 percent still had language or learning difficulties. Half were diagnosed with "externalizing" behavioral disorders – such as ADHD and oppositional rebellious disorder – while a quarter had "internalizing" mental health, including anxiety disorders and obsessive compulsive disorder. Two children had more severe psychological disorders with psychosis.
There were three children, the researchers added, providing no "justification" for an alternative diagnosis.
Those children, Connell said, probably never had autism. "Most researchers agree that children are never" cured "from autism – it just becomes less clear," he said.