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.

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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 TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland‘s Facebook page and on Twitter at @TIMEHealthland.

8 comments
JacobLanctot
JacobLanctot

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---

http://anthillsandmountains.blogspot.com/

winn11.lorraine
winn11.lorraine

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-

worldviewer
worldviewer

#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?

worldviewer
worldviewer

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. 

ParentontheEdge
ParentontheEdge

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.

MillyLanders
MillyLanders

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.

ParentontheEdge
ParentontheEdge

Just wanted to add that we didn't start to have success with our son until we removed him from school.  The school environment was simply to stressful for him.  I would suggest that until low stimulation learning environments are available to parents many children will not be able to "bloom".  I wonder whether one of the reasons children from high socio-economic backgrounds were able to do well because they were able to afford to provide such an educational environment for their children.  In our case this meant one parent giving up work and study to home school our child until he was able to reenter mainstream school.

JacobLanctot
JacobLanctot

@MillyLanders  I Have autism I have never got the seizure but I do get really bad migraines. I have discovered how to tell if I'm going to get a migraine a few hours before it happens. Perhaps you can watch your granddaughter and see if this helps. Some of the glorious symptoms of autism is the annoyance of bright lights, the flashing and noise from florescent lights, and noise.


At 21 years old I have been able to block out most of these for short periods of time. When I wake up and I'm not able to ignore these and an annoyed by small things that normally wouldn't bother me I can suspect a migraine that day. Discovering this recently I then know not to push my limits that day with little things like not staring at the computer screen Staying away from noisy places and taking a nap that day. I hope this can help your granddaughter.