Can Autism Be Outgrown?
By Mir Kamin on January 17, 2013
BlogHer Original Post
Let's look at some of the conclusions drawn in this study.
Thirty-four OO participants had a clear documented history of ASD, yet no longer met criteria for an ASD as per the ADOS and clinical judgment. Sex, age, nonverbal IQ, and handedness did not differ among the three groups. VIQ was 7 points lower in the HFA group than in the TD and OO groups, which were virtually identical and in the high average range. OO Communication and Socialization ADOS scores did not differ from the TD scores, although seven OO participants were judged to have social functioning mildly affected by nonautism conditions, such as anxiety, depression, or impulsivity [emphasis mine]. The number of OO and TD subjects who showed total social and communication ADOS algorithm scores above zero were not significantly different.
The first place I take issue here is with the assertion that anxiety/depression/impulsivity are somehow completely unrelated to ASDs. I mean, yes, those are not part of the autism diagnostic criteria. But all of those conditions are considered associated symptom domains, meaning that you are highly likely to find them along for the ride with ASDs. So noting that "Hey, this group that is supposedly no longer autistic does still show social impairment due to these things we know to often occur in conjunction with autism, but it probably doesn't mean anything" feels a bit disingenuous to me.
Let's go back to my own HFA-labeled son for a moment. I wouldn't bet you a huge sum of money, but I'd probably bet you $10 or so that he could've gotten through this testing and been assessed as having only mild social impairment. I would make that bet because 1) he often experiences little or no social impairment under optimal circumstances (such as knowing exactly what to expect and what is expected of him) and 2) this is a child who has had years of targeted therapies to help him manage his emotions and behavior in socially acceptable ways. See, that's what happens when you get an ASD diagnosis, if you're lucky -- you commence appropriate treatment, and things get better. That doesn't mean my son no longer has autism or that he's never going to experience difficulty because of it, it just means that he is less severely impacted than he was before he began working on his toolbox of coping skills. Time, maturity, therapies, and a careful curation of what circumstances he's forced to navigate, all combine to make for a life more manageable. That's not magic or outgrowing, that's just... progress.
So even though this particular study concludes:
The purpose of the current study was primarily to demonstrate the existence of a cohort who had clear autism at a young age and no longer demonstrated any significant autistic impairments. The data clearly support the existence of this group. The possible presence of subtle limitations or differences in social behavior, social cognition, communication, or executive functions remain to be elucidated in further analyses, as do many other crucial questions, such as the biology of remediable autism, the course of improvement, and the necessary and sufficient conditions, including treatment, for such improvement.
... I feel like saying "the data clearly support the existence of [a group once diagnosed ASD but no longer clinically autistic]" is a stretch. Maybe some of the subjects in that group were incorrectly diagnosed in the first place. (There's certainly a number of other conditions which can mimic autism's symptoms, and some -- like certain food sensitivities -- can indeed be outgrown.) Undoubtedly some of those subjects have improved via any number of channels -- maturity, therapies, medications -- and may now be "flying under the radar" in limited situations. And quite probably a conclusion this broad-sweeping is a bit premature when the methodology utilizes a relatively small sample size, no field observation, and nothing even remotely longitudinal to back it up.
I worry that studies like this change the focus from helping our kids live full and happy lives in a world that values their neurodiversity back to the old "Cure Autism Now!" battle-cry, one that doesn't make any sense if you embrace the current research showing autism to be biologically-based.
What do you think of this study? Interesting, foolhardy, incomplete? Did it make you bristle the way it did me?
BlogHer Contributing Editor Mir Kamin thinks her kids are awesome just the way they are. She blogs near-daily about issues parental and otherwise at Woulda Coulda Shoulda, and all day long about the joys of mindful retail therapy at Want Not.