Predictors of optimal outcome in children with an Autism Spectrum Disorder

A diagnosis of an Autistic Spectrum Disorder (ASD) is generally thought to be stable over time. In the current study, 19 children who were diagnosed with an ASD at age 2 no longer met criteria for a diagnosis on the autistic spectrum by age 4, at which time they scored within the normal range on standardized measures of cognitive and adaptive functioning. No differences between children who attained the most positive outcome and those who did not were found at age 2 in adaptive communication, socialization, and daily living skills, receptive language ability, functional and symbolic play, or stereotyped behaviors and restricted interests. Children who lost their diagnosis of an ASD by age 4 were more likely to have better motor skills, nonverbal cognitive skills and expressive language ability, and observed communication and social interaction skills than their peers who made fewer gains. Children who moved off the spectrum were also more likely to be diagnosed initially as Pervasive Developmental Disorder not otherwise specified, and were likely to have less severe symptoms. The results of the current study support previous studies which suggest that children identified very early as having an ASD can lose their diagnosis, and it is difficult to identify these children and predict outcome at age 2.