Autism Prognosis

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By Dr Ananya Mandal, MD

Autism is a complex disorder with a variety of manifestations and is thus termed Autism Spectrum Disorders or ASD. There is no known cure for this condition. Children with autism may often grow up with lack of social support systems, employment and meaningful relationships and family. Overall this leads to severe lack of self esteem. Symptoms tend to become less severe with age but with most patients with severe autism independent living is unlikely.

Prognosis or outcome of autism

Some children with autism may improve at 4-6 years of age especially those with mild autism who have been treated at an early age. These children who improve may be able to include themselves among their normal peers. Current policy of inclusion within the education system helps to support the majority of ASD sufferers within mainstream schools.
Results from surveys show that 49% of adults with autism still living with parents and only around 12% have full time employment.
A 2004 review of autistic adults diagnosed as autistic children with IQ above 50 in UK found that 12% autistic adults achieved a high level of independence as adults. 10% had a social life and some employment but required some support, 19% had some independence but were living at home. 46% needed specialist residential provision and 12% needed high-level hospital care.
In another Swedish study in 2005, it was noted that of all adults with autism only 4% achieved independence. This study included all sufferers of ASD irrespective of IQ.
Prognosis also depends on co-existing mental retardation. 25% to 70% of ASD sufferers may have varying degrees of mental retardation. For ASD other than autism, the association with mental retardation is much weaker.
With rising awareness about autism more and more parents are amenable to early screening especially of high risk children
It is also seen that reported cases of autism increased dramatically in the 1990s and early 2000s. This increase is largely attributable to improvements in diagnostic practices and public awareness. Other factors such as environmental toxins, advanced parental age at the time of pregnancy etc. may also be important.
Prognosis also depends on diseases that co-exist with autism. These include genetic disorders like Fragile X syndrome, Down’s syndrome etc. About 10–15% of autism cases have an identifiable chromosomal abnormality.

Reviewed by April Cashin-Garbutt, BA Hons (Cantab)