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Early Intervention Helps 1 in 14 Toddlers Overcome Autism Symptoms

But almost all of these children still need special-education services for emotional, behavioral or learning issues in grade school
April 24, 2015

One in 14 toddlers entering an early intervention program in the Bronx overcame their autism symptoms by grade school. But the vast majority continued to struggle with emotional or behavioral issues that warranted special-education services.

Lead researcher Lisa Shulman, of New York City’s Albert Einstein College of Medicine, presented her team’s findings today at the annual meeting of the Pediatric Academic Societies, in San Diego.

Previous research has shown that autism symptoms resolve in a small subset of children, most of whom have received intensive early intervention. It’s not been clear, however, if these children continue to struggle with other emotional, behavioral or learning issues.

The researchers tracked 569 children diagnosed with autism as toddlers. They re-evaluated the children before they entered elementary school – on average 4 years after they began receiving early intervention services.

The re-evaluations showed that 38 of the 569 had improved to the point that they would no longer receive a first-time diagnosis of autism. Autism is considered lifelong. So children don’t “lose” their diagnosis, even with dramatic improvement.

In addition, most of the 38 children had tested as intellectually disabled (IQ below 70) as toddlers. On re-evaluation, all of them scored within a normal intellectual range.

But despite these improvements in social and intellectual abilities, 35 of the 38 children (92 percent) still needed mental health or special-education services.

Rough two-thirds of these children had some type of language or learning disability. Nearly half had behavior problems such as attention-deficit/hyperactivity disorder or disruptiveness. One in four had emotional disorders such severe anxiety or obsessive-compulsiveness. And nearly three out of four still needed some type of special-education services.

"When an early ASD diagnosis resolves, other learning and emotional behavioral diagnoses often remain," Dr. Shulman concludes. "Understanding the full range of possible positive outcomes in this scenario is important information for parents, clinicians and the educational system."

Autism Speaks Head of Medical Research Paul Wang comments:

“This bolsters what we’ve learned about early intervention helping some children with autism achieve a so-called optimal outcome, where their autism symptoms resolve. More importantly, perhaps, the findings tell us that these children still need continued support for other aspects of their language and behavior – as Dr. Shulman notes. Of course, we must also continue to improve treatments for the vast majority of children and adults who do not respond so strongly to current interventions.” Dr. Wang was not involved in the study.

View the full study abstract, as presented at the Pediatric Academic Societies meeting here.

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