Children with autism who have severe symptoms at diagnosis usually improve very little over time, while those who are high functioning improve more rapidly in their social and communication skills according to Peter Bearman, PhD, of Columbia University in New York City, and colleagues.
But a small subset of children – 8% to 11% – show dramatic improvement in communication and social skills from low functioning to high functioning, the researchers reported online ahead of the May issue of Pediatrics –
“More work is needed to discover whether these longitudinal patterns will help us not only to understand the diversity of autism but also to better target interventions and improve treatment,” they wrote.
The study “Six Developmental Trajectories Characterize Children With Autism,” utilized annual evaluations for 6,975 children with autism inCaliforniaand discovered a subset of children dubbed “bloomers”. These children are severely affected by autism at age 3 but seem to have “bloomed” by age 8, leaving behind many of the condition’s crippling deficits. While these “bloomers” still retain some of autism’s symptoms, like the tendency to rock back and forth when stressed or to repeat the same behavior over and over, they become “high functioning,” according to the study.
A child at the low end of the communication scale might not be able to talk, or even to make any sounds, explained the one of the study’s authors Christine Fountain, a postdoctoral fellow atColumbiaUniversity. Those at the other end of the scale “would have a broad vocabulary, understand the meaning of words and use them in appropriate contexts, understand the meaning of story plot and carry on complex conversations,” she explained.
The most rapid improvements were typically seen before age 6, the researchers said. More research is needed to understand what puts children with autism on a “blooming” path, and whether anything can be done to get them there, Fountain said.
After scrutinizing the differences between children who bloomed and those who didn’t, the researchers determined that it likely comes down to which kids were able to get early, intensive therapy since the children who improved the most had parents with more education and financial means.
“These socioeconomic disparities suggest that equal access to early interventions and services for less advantaged children is going to be really vital,” Fountain comments.
“Most children need about 30 to 40 hours a week of intervention,” said Tamar Apelian, a staff psychologist at the autism evaluation clinic at theUniversityofCalifornia,Los Angeles. “What’s tricky is being able to navigate the system to get the therapy, especially with the state budget crisis. The parents who do this seem to have more means and they can hire an advocate or a lawyer.”
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