Deborah Fein, PhD, was a psychologist in the 1970’s and became fascinated that a few of her patients with autism spectrum disorder had become symptom free by age 7. Since then, it has become clearer that a small subset of children do, clinically speaking, lose the ASD diagnosis—ranging from 3 percent to 25 percent of young people initially diagnosed with the disorder, according to research.
While Fein still cannot predict which children might lose an ASD diagnosis, there are certainly clues as to why some do. One is that those with ASD who go on to function well—whether they have lost the diagnosis or not—start out with higher IQs, better language skills, fewer repetitive behaviors and greater ability to engage in imaginary or symbolic play than other children with ASD. Many children who appeared to lose the ASD diagnosis developed attention problems, including attention-deficit hyperactivity disorder.
A successful intervention done by psychologist Ivar Lovaas, first developed applied behavioral analysis (ABA). While the original method is no longer used (it included the use of aversive techniques), newer forms of the intervention, such as early intensive behavioral intervention, or EIBI, reward children for learning positive behaviors and skills.
Developments in Assessment
An instrument called the Early Skills Assessment Tool (ESAT) uses repeated observations of cognitive and social skills relevant to ASD—including play behaviors and joint attention, or the ability to share the focus on an object with another person—to capture changes in behavior.
Future Prognosis
Researchers also want to know how the children who lose their ASD symptoms fare over time as they face the more complex social and executive-function demands of being in college, finding and keeping a job or having adult relationships.
Reference:
DeAngelis, T. (2019), “Losing an Autism Diagnosis”. Vol. 50. No. 4. Pg. 22. American Psychological Association.
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