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Saturday, May 2, 2015

Autism Resolves in Some Kids, but Difficulties Linger

From PsychCentral

By Rick Nauert Ph.D.
April 27, 2015

Emerging research suggests about one in 14 toddlers diagnosed with autism spectrum disorder (ASD) will improve and no longer meet the diagnostic criteria in elementary school.

In this public service video for parents, Lisa Shulman, M.D.
uses video of babies and toddlers to show the communication
milestones expected in typically developing children. She also
discusses what parents should do if they suspect
their child is developmentally delayed.

However, investigators determined most will continue to have emotional/behavioral symptoms and required special education supports.

The study was presented at the Pediatric Academic Societies (PAS) annual meeting in San Diego.

Previous studies have also shown that ASD symptoms resolve in some children over time. It is not clear, however, if these children continue to have cognitive, behavioral or learning deficits.

Researchers, led by developmental pediatrician Lisa Shulman, M.D., reviewed data on 38 children diagnosed with ASD in 2003-2013 whose symptoms had resolved when they were re-evaluated about four years later.

The children were among 569 children living in the Bronx who had been diagnosed with ASD by a multidisciplinary team at a university-affiliated early intervention program.

The children came from racially, ethnically and socioeconomically diverse backgrounds, a population generally underrepresented in autism studies. Forty-four percent were Hispanic, 36 percent were Caucasian, 10 percent were African-American, and 46 percent were on Medicaid.

Clinicians who made the original diagnosis also provided interventions and monitored response to treatment. Over time, they noted that ASD symptoms in some children resolved, but most continued to have other learning and emotional/behavioral symptoms needing attention.

“Autism generally has been considered a lifelong condition, but seven percent of children in this study who received an early diagnosis experienced a resolution of autistic symptoms over time,” said Shulman, director of Infant and Toddler Services at the Albert Einstein College of Medicine/Children’s Hospital in New York.

“The majority of the children at original diagnosis displayed intellectual disability but at the point of resolution of autistic symptomatology displayed normal cognition,” Shulman added.

Although the social impairment of autism resolved and cognitive functioning (IQ) improved, researchers found that 92 percent of the children had residual learning and/or emotional/behavioral impairment. Only three of the 38 children had no diagnosis.

Language/learning disability was found in 68 percent, and nearly half had externalizing problems such as attention-deficit hyperactivity disorder or disruptive behaviors.

In addition, 24 percent had internalizing problems such anxiety, obsessive-compulsive disorder or selective mutism. Finally, nearly three-quarters of the children continued to require academic supports, such as a small class setting or a resource room.

“When an early ASD diagnosis resolves, there are often other learning and emotional/behavioral diagnoses that remain,” said Shulman.

“Understanding the full range of possible positive outcomes in this scenario is important information for parents, clinicians and the educational system.”

About Lisa Shulman, M.D.

Lisa Shulman is a neurodevelopmental pediatrician, an associate professor of pediatrics at the Albert Einstein College of Medicine and Director of Infant and Toddler Services and the RELATE program at Einstein's Children's Evaluation and Rehabilitation Center.

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