Autism: Why Some Children ‘Bloom’ and Overcome Their Disabilities

About 10% of low-functioning children with autism may "bloom" and outgrow most of their severe disabilities by adolescence.

  • Share
  • Read Later
Charly Franklin / Getty Images

A new study offers some good news for families with autism. Most children affected by the disorder do not have intellectual disabilities, the study finds, and even among the severely low-functioning, about 10% may improve dramatically over time, with some growing out of their diagnosis by their teens.

The study tracked nearly 7,000 autistic children born in California between 1992 and 2001. The group included most of the children who received an autism diagnosis in the state during that time period. The kids were followed from diagnosis to age 14 or the oldest age they had reached by the time the data collection was concluded.

The researchers found that 63% of the children did not have intellectual disabilities. Although autism is known to cause cognitive deficits in some children, it is also associated with certain enhanced intellectual abilities, and some affected children have extremely high IQs.

About one-third of the study group were considered low- to low/medium-functioning in terms of communication and social skills, meaning that they may have trouble talking, interacting with others or socializing and making friends with peers.

High-functioning kids with autism, meanwhile, can communicate effectively with others, maintain friendships and are willing to engage in social pursuits. While the highest-functioning children tended to show the most improvement over time in the California study, about 10% of those who started out in the low-functioning group also moved into the highest group by age 14.

MORE: Autism Rises: More Children than Ever Have Autism, but Is the Increase Real?

“The critical finding is that when you look at those children that this study refers to as ‘bloomers’ — the children who seemed very low-functioning at the beginning and then did extremely well — they [tend not to] have any intellectual disabilities,” says Rahil Briggs, assistant professor of pediatrics at Albert Einstein College of Medicine, who was not associated with the research. Low-functioning children without intellectual disabilities were twice as likely to “bloom” as those who had cognitive deficits.

Briggs adds that another “very key” factor is that the mothers of the kids who bloomed tended to be more educated and not minorities. This suggests that low-income immigrant or minority families may not be receiving the services and support for their children that educated, affluent parents are able to access more easily.

With developmental disorders, the earlier a child receives help, the more likely he or she is to overcome disabilities. Early intervention matters because the brain is remarkably vulnerable early in life, built to shape itself to the environment it initially faces. “The young brain is disproportionately receptive to input, whether positive or negative,” says Briggs. “That’s why young children can learn a second language easily and why early exposure to domestic violence and toxic stress are so incredibly damaging.”

If autistic children receive intervention before such coping mechanisms as repetitive behaviors and extreme social withdrawal are firmly entrenched, for example, their innate oversensitivity to their environment is far less likely to become or remain disabling, and their other abilities and gifts can flourish. If these children are reached early enough, “we can actually start to change brain functioning if we provide the right kind of repetitive and focused intervention,” Briggs says.

MORE: Understanding Why Autistic People May Reject Social Touch

The American Academy of Pediatrics currently recommends that doctors screen children for autism at their 18-month well-child visit. Briggs adds that parents must become aggressive champions for their children. “So much can depend on how good that parent is at advocating for the child,” says Briggs, noting that parents need to be aware not only of what services are available, but also which ones are best, which are not helpful and how to get the best care.

“That puts an incredible burden on parents,” she acknowledges. With the Centers for Disease Control and Prevention reporting last week that autism now affects 1 in 88 children, it is becoming a burden shared by more and more American families.

Briggs says that the findings in the new study reflect the types of developmental trajectories she sees in children in her practice as director of the Healthy Steps program at Montefiore Hospital in the Bronx, which helps disadvantaged families access numerous services, including autism therapies, through their pediatricians’ office visits.

She describes working with a 5-year-old autistic boy and his family. The family said he would come home from kindergarten crying, but they couldn’t figure out what was wrong. Finally, he described how he felt while he waited for his mother to pick him up in the school’s cafeteria: “There were so many echoes bouncing off the walls that it felt like people were having a party in my head and they wouldn’t turn down the music,” he said.

Identifying the problem led Briggs to enroll the boy in listening therapy, which helped him cope with his sensitivity to sounds. When such sensory issues, which are common in autism, can be mitigated, children become far less stressed and far better able to learn other skills like social interaction and communication.

Most children from disadvantaged backgrounds aren’t able to get these kinds of services, however. “If we still see these huge differences in children with autism based on socioeconomic factors, we clearly don’t have enough programs or haven’t made them available enough,” Briggs says.

The research was published in Pediatrics.

MORE: Brain Imaging Could Detect Autism Risk in Infants as Young as 6 Months

Maia Szalavitz is a health writer for Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland‘s Facebook page and on Twitter at @TIMEHealthland.


I am soon 50 yr old with youth diagnosed Asperger's, I have dyslexia. I have a hereditary blood disorder.  A severe head injury at 30 which caused regressive setbacks I had to work past. I am the social end. I was able to parent my two slightly affected older children past the hump of Asperger symptoms. They are now grown, my daughter pursuing an art  college and my son  MIT,  husband was diagnosed with childhood learning disability and has severely autistic cousin. The testing was not as available in the 90s as when My youngest comes from a family that has autism prevalent (3 other members all first cousins, one the father's cousin). I was aggressive about his migraines and other symptoms that they tried to brush off as probably outgrown by age 3 <_<. I do wonder if the high fever his unnecessary  mandatory vaccine set caused a stroke. After his autism diagnosis they have done dna but no mri. He has extra material on 14.

Though lumped together I do not think Autism and Asperger's are same unless you want to call Alzheimer adult autism. My youngest takes all my focus to handle. He is nothing like other kida in my family with Aspergers. We were all verbal, social, skittish to touch. Most were math geniuses 

 The comments about  finance are not correct. I had more assistance with youngest as a unemployed niched into "hispanic/native american that I ever got as white looking redhead married to uberwhite russian in the 50k bracket. Though education may  be obstacle of confidant disagreement with professionals; Aggressive parental action=the key. Insisting against "suggested " coursed to  define what MY child responds best to. He has suffered terribly and regressed under the programs here in NC compared to how he flourished in AZ and in one FL program. My only option was to home school this past year which was very difficult  for me. My children and I like opulent soothing fabrics. We are jumpy to water in our face or things brushing our faces. We have skittish period on being touched by people or having them all hulking and lurky around us before we adjust. I have dog hearing and dog nose for environment. My daughter outgrew that. I am commenting so late  so that I can tell other parents that google across this. Don't let them cubbyhole YOUR child for THEIR convenience. Fight.  Especially during the crucial time that it can be reversed best with therapy. And hard it may be, be patient and even with no verbal..they are listening.  They are learning. Application is the hurdle they must  clear.


I am 21 going to college and am held back from the disabilities that are associated with autism. Engineering is hard, ever header not being able to read or wright at any effective speed. As I was growing up my mother wise the biggest help, We didn't have money for professional help, But my parents made it happen. To be honest it didn't help that match, what did help was my mother Saying "YES YOU CAN" when ever I was told I couldn't live up do a task. My life has been filled with overcoming both ant-hills and mountains. Ranging from the conversation game that come so naturally to most people to the over stimulation of my senses when I am trying to concentrate.

To over come my reading and spelling I have started a blog, Here is a quotes from the book we are starting to read "This book is dedicated to all parents everywhere, a child's most important teachers." ----Robert Kiyosaki---


I don't care for the comparison of disadvantage or minorities it is either you have a parent that is in tune with the needs of their child being ASD or not and if the parent is aware they will put in the effort to create the support the child needs. Granted the more money you have the better access to better services but that is with everything you do in life. It is important to have money so that you can provide the support your child needs but the comparison as if that is the only factor is flawed and not needed. Some people live in more remote places and the services are not available even if they have the money to pay for the service. The comparison of minorities is yet again another way to divide and conquer and AUTISM is more important than that-


@winn11.lorraine I have spotted there was something wrong with my son since he was three years old. Unfortunately I was patted on the back so to speak and told everything was fine. I went back and insisted on seeing a specialist and told my son can read and speak confidently and everything will come out fine in the wash! 

My son at school struggled, yet his brothers excelled. I again insisted something was not right, I taught him at home after school but he couldn't retain. Again I was told not to worry. I was when I moved to Essex from London that the school agreed with me. My GP again dismissed this, so I asked the school head could she write to my doctor and insist for Max to see a specialist. My son Max is four years below his peers. The school and I have faught for Max to have a statement, again I have been turned away.

It is very ignorant to put Mothers in a box and say they don't know or are not active enough. My son has now been labled with ADHD, but I believe he is autistic which I have been told he is not due to him being social.

Max has many hours of flapping and rocking his body, an eager to please people, doesn't see danger, wants shoes off and clothes off (pajammas on) Likes being repetitve and often fixated for a long period of time on one thing. 

Max is starting secondary school next month which is a great worry to me. Children comment on him and he now says he feels different from children. He plays with younger children and feels easier to connect with them.

I am still on my struggle with Max unfortunately. Being dismissed from professionals, but I am still not going to give up. 

In addition, many mothers like me have been patted on the back and told everything is ok when they seek help. It should be looked into how many mothers do go to their doctor and ask for help, but are turned away. 


#2  Human babies have, by far, the greatest post-natal brain development of all living creatures--the brain doubling in volume in the first year.  For thousands of years women carried their babies with them as they worked.  Maybe autism is increasing because women are expected to go to work, sometimes within two weeks of birth so there's a weakening of the bond between mother and child.  ("mother" = consistent, committed caregiver)  

The decisive time to evaluate is in the first months--and no, it can't be very scientific, as doctors would like it to be.  They could have a creche group for an evaluation over a period of hours, days or weeks.  Expensive?  Is it cheaper to have to have life-long support for a developmentally disabled person?


The difference is in PARENTING!  and ATTACHMENT!  A mother with secure attachment will parent her autistic child better.  A mother who was abused as a child will have deficits in her ability to relate to and to help promote her child's abilities and help overcome their deficits.

My sister has an autistic son. I first saw him when he was 11 months old.  In a week he never made eye contact with me, so I knew he had already missed many developmental milestones.  I tried to talk to her about it but she had been so shamed by doctors who pooh-poohed her concerns that we couldn't talk about it until many years had passed.  If she had been raised differently she would have had the confidence to ignore the judgement of doctors who saw her son for a few minutes while she was interacting with him for hours every day. 


This is an interesting article and I am pleased to say I have evidence of its findings in my own small way both my son with mild Autism and a friend's son who had more sever Autism seem to have been able to "bloom".  I am wondering if the outcomes for medicated children were included in this study as in my limited experience medicated children seem to do more poorly.  Neither my son or my friend's son were medicated.


Hooray! Some children at some point in their lives will not be autistic.  However, right now my grand daughter, age 5, dx with autism, non-verbal, seizure disorder, in special education at local school district program 5 days a week, outside therapies have been speech and ot.  Outside speech (I designate it as such because it is not associated with school district and is filed with the family health insurance program) is on hold because of "staffing" which really means the provider cannot find a  speech therapist. We are in a large metropolitan area in Texas and the facility is moving therapists from main campus to satellite campus for coverage of services.  Not good.  One  last comment,  family health insurance says we aren't going to pay for "brand" seizure medication for your five year old daughter because there is a generic available. My grand daughter is 5 years old, she had her first seizure at 9 months, she has never been able to go two years without a seizure which means until she is seizure free for two years continuously she cannot stop taking seizure medication. She has been on brand seizure medication since she was a toddler.  Insurance companies aren't the drug police; we have internet, we know how to research drugs. We also have to have a trusting relationship with our doctors......especially for our little ones.